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The Bear River Health Department is working to contain a measles outbreak in Cache County that has spread to four people.

"We have three new cases of measles confirmed [Monday] in Cache County. That brings our total to four cases," said department spokeswoman Jill Parker.

One adult and three children between the ages of 5 and 17 have been infected by the highly contagious virus. Parker didn't know if any of the four had been vaccinated.

The three new cases were "close contacts" of the elementary-age child who became the county's first confirmed case on May 30. That child had traveled to Salt Lake County, where a measles outbreak recently ended. Parker said the health department is still trying to determine if the child was infected in the Salt Lake area.

The health department is reaching out to anyone who has come into contact with the four infected individuals. With school out last week, the largest public gatherings affected are church congregations, she said.

The four individuals have been asked to isolate themselves. Those who have come in contact with the four who haven't received two doses of the measles, mumps, rubella vaccine could be asked to quarantine themselves as well.

The vaccine is considered 99 percent effective after two doses.

Measles causes fever, runny nose, cough and a rash. Nearly one-third who get the measles develop complications that can include meningitis, pneumonia, seizures, encephalitis, blindness and brain damage.