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As of Wednesday, the Clark County Public Health Department had confirmed 50 cases of meales since January 1.

The European Vaccine Action Plan 2015-2020 (EVAP) lays out a strategy endorsed by all 53 Member States to eliminate both measles and rubella. Only 81% of 1 to 5 year olds in the county have received a dose of MMR, according to Clark County, Washington Public Health.

The Northwest cases are among three ongoing measles outbreaks in the US that sickened 79 people in January, according to the CDC.

While the USA faces measles outbreaks from NY to Washington state, reigniting discussions about the risk of parents who refuse to vaccinate their children, Madagascar has been fighting the worst eruption of the disease in decades. About 1 in 20 children with measles contracts pneumonia, and in rare cases measles patients may experience encephalitis - inflammation in the brain. The risk of death due to measles is greater for infants and adults than for children and adolescents. Between January 13 and February 2, 2,739 children and 1,754 adults were vaccinated compared to 630 children and 60 adults over the same period previous year.

Clark County Public Health Department Public Information Officer Marissa Armstrong said that the first case in the Clark County outbreak was a child who had traveled to Clark County from outside the country - information that was announced in the initial outbreak news release January 4.

Dr. Robinson wrote a statement a year ago for the Canadian Paediatric Society on problems with vaccination rates in Canada.

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That helps explain why public health officials get so concerned when outbreaks occur, which they have been with increasing frequency in recent years.

Washington and OR are among 17 states that allow non-medical exemptions from vaccination requirements for school entry, according to the National Conference of State Legislatures.

The other reason, Melnick says, is that there is an highly organized and sophisticated anti-vaccination movement "spouting nonsense" on social media.

Although we are left to speculate about the next location of a measles outbreak, it's clear that if vaccination coverage does not increase, it will only be a matter of time until we find out. "We have vaccines that are very cheap, very effective, and very, very safe".

That's a huge rise in a county where vaccination rates lag - only 76.5 percent of kindergartners had all the required immunizations for the 2017-18 school year.

World Health Organization said "uneven progress between and within countries" was to blame.