There are six measles outbreaks in the U.S. including one in Illinois, one in Texas, one in Washington state, and three in New York. So far this year there have been 159 cases of measles in the U.S. That’s more in the first two months of the year than in all of 2017 or 2016.

Washington County Public Health Administrator Danielle Pettit-Majewski explains that measles is highly contagious and is spread through the droplets of coughs or sneezes that can be picked up on surfaces or in the air hours after someone carrying measles has coughed, “And you have an incubation period of about 10-12 days, so you could be exposed and then 10-12 days you’re going to start seeing symptoms. However, four days before you see symptoms you can be infectious, so that’s what makes this so dangerous because people are exposing children, exposing unvaccinated populations, exposing immunocompromised people without even knowing that they’re infected.”

Pettit-Majewski and the Centers for Disease Control recommend getting a vaccine to prevent contracting or spreading the disease. She says that for every 20 people who get measles, one gets pneumonia; one out of 1,000 get encephalitis, swelling of the brain; and one or two out of 1,000 people with measles die. Nearly 20 years ago it was thought that measles had been or was nearly eradicated in the U.S. Measles presents with a red, spotty rash that begins on the neck and face and then spreads down over your body and can lead to pneumonia.