Public health officials are warning of measles exposure as the disease spreads on a global scale.

At least 46 children have died in Bangladesh, with about 684 measles cases confirmed in the country since late January, according to Reuters.

Government officials recently announced deaths linked to measles after laboratory testing of 33 samples.

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“Of the tested samples, 15 deaths ⁠have been directly linked to measles infection,” said Health Services Division Secretary Kamruzzaman Chowdhury in a statement.

Bangladesh has modified its vaccine schedule after health officials found a significant share of measles cases were occurring in infants younger than 9 months, who are not yet eligible for routine vaccination, according to local reports.

World Health Organization guidance recommends that children receive two doses of the measles, usually given at 9 months of age in countries where measles is common and at 12-15 months in other countries. The second dose should usually be administered at 15-18 months.

In the U.S., as of March 26, 1,575 confirmed measles cases had been reported by the Centers for Disease Control and Prevention.

There have been 16 new outbreaks reported this year, with 94% of confirmed cases deemed outbreak-associated, per the CDC.

The agency attributes the spike in measles activity to a trend of lower “herd immunity” in communities — meaning vaccination rates have fallen below the roughly 95% threshold needed to prevent outbreaks.

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“U.S. national MMR coverage among kindergartners has decreased and is now below the 95% coverage target,” the CDC states on its website.

Measles symptoms include a high fever, cough, runny nose, watery and red eyes, and a rash that usually appears between three and five days after symptoms start, according to medical sources.

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The rash usually begins as flat red spots that appear on the face at the hairline and spread downward to the neck, torso, arms, legs and feet.

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The airborne virus can spread when someone coughs or sneezes. Measles is known to stay in the air for up to two hours after an infected person leaves the area.

Reuters contributed to this report.