One case of measles confirmed in Bell County

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An additional case was confirmed in King County, which includes Seattle, and in Multnomah County, Oregon, which includes Portland and lies across the Columbia River from Clark County.

The rapid spread the virus prompted Washington Gov. Jay Inslee to declare a state of emergency at the end of January, saying the outbreak represented an "extreme public health risk that may quickly spread to other counties". Health officials have long anxious about the potential for an outbreak in the region.

While more children in Europe are being vaccinated against measles than ever before, progress has been "uneven" between countries and individual countries have some patches where vaccine take-up is low, it said. Orders of measles vaccines in the county reached 3,150 in January. That is almost a 500 percent jump in orders from January past year, when the total was just 530. Statewide vaccine figures also reflect a boost. Doctors say one dose of the MMR [measles, mumps, rubela] vaccine is about 93 percent effective.

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Though health officials are glad to see the surge in life-saving immunizations, the motivation is less encouraging. Joan Robinson, a pediatric infectious diseases physician and editor of the Paediatrics & Child Health Journal, said that outbreaks often occur in small communities where children aren't vaccinated. The infection is easily preventable by a vaccine. "We may never know who "patient zero" is and ... it doesn't have any impact on how we're responding to this outbreak".

Measles is caused by the measles virus, which can be spread through the air by coughing or sneezing. If other people breathe the contaminated air or touch a contaminated surface, then touch their eyes, noses or mouths, they can become infected. Measles is so contagious that if one person has it, 90 percent of the people close to that person who are not immune will also become infected. Among the confirmed cases, 43 were not immunized against the highly contagious disease.

Separately, five additional cases were confirmed in the Houston metro area Monday, including two boys younger than 2 in Harris County, prompting health officials to urge residents to "protect their children and themselves from this disease by getting vaccinated". Measles infection can have serious complications such as pneumonia, seizures and encephalitis (inflammation of the brain). Measles can also cause pregnant women to give birth prematurely or deliver a low-birth weight baby.

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