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Four Utahns have now been confirmed to have the measles, and health officials have identified six more suspected cases in what is shaping up to be the largest outbreak in a decade.

The six suspected cases are in children from toddlers to teens, some of them siblings, said Gary Edwards, executive director of the Salt Lake Valley Health Department. He couldn't say where they attend school.

But the number of schools affected by the outbreak jumped from two schools to four over the weekend. Staff at Skyline High School and Evergreen Junior High spent the weekend poring over immunization records to identify students who are not fully immunized against the virus and notifying parents to keep those children home until April 25.

They flagged 29 students at Skyline and 13 at Evergreen for possible exposure, said Granite spokesman Ben Horsley.

Similar actions were taken last week at William Penn Elementary and at Olympus High School, where the outbreak started, bringing the total number of affected schools to four. All the schools are within the Granite School District.

The first confirmed case was an Olympus High student who tested positive on Wednesday after returning from a trip to Europe. At least two other confirmed cases are linked to Europe and the Olympus High teen.

One person was briefly hospitalized, said Edwards. None had been vaccinated.

"The vaccine is very effective against this illness," which is why the only students excluded from school have been those who are not fully immunized, he said.

The last suspected case of measles in Utah was in 2005, and the last outbreak was in 2000 in Summit County, which totaled three cases.

Because measles is so contagious — nine of 10 nonvaccinated children who are exposed will get the disease — one confirmed case is considered an outbreak.

Health officials are interviewing those newly infected to identify anyone with whom they've been in contact from four days prior to the appearance of the tell-tale rash to four days after. They also chart the comings and goings of each infected person and notify employers and places they've visited, such as restaurants, said Edwards. "We have contacted some grocery stores and some fast-food outlets."

With each day costs mount for the health department and school district, though neither could provide an estimate.

"Each outbreak is different," said Edwards, adding it is hard to compare this one with a 107-person outbreak in Washington County in 1996, which cost $600,000. Back then few school-age children had received a second vaccine dose, which wasn't required until 1990, Edwards said. "Now all grades should have had the required dose. ... So this one may play out differently."

Salt Lake Valley Health Department hasn't exhausted its stockpile of vaccines, but hopes to replenish supplies by tapping the federal storehouse, said Edwards. —

What is measles?

Measles causes fever, runny nose, cough and a rash. The virus is spread by respiratory droplets such as coughing, sneezing and by direct contact with secretions from an infected person.

More info on measles

How deadly is it? • Most recover with time, but 30 percent suffer complications that can lead to blindness or death, including meningitis, pneumonia, seizures and encephalitis.

How it's prevented • Vaccine. Children should get two doses and adults born after 1957 who may not have been immunized should contact their doctor to see if they need the vaccine.

What if I've been exposed? • Health officials stress voluntary quarantine for anyone exposed, which means staying home from school, work, church and recreational activities. If a child who was exposed and has not yet reached 4 to 6 years of age, recommended for a second vaccine dose, ask a doctor about getting it.