BOWBELLS, N.D. — More cases of

measles

have been identified in North Dakota, including in a previously uninfected county.

The North Dakota Health and Human Services Department announced on Thursday, May 29, the state’s 28th case, up seven from last week.

The latest case was the first reported in Burke County in far northwest North Dakota. The release did not identify the age of the infected individual but said they traveled frequently to

Williams County, where the first case was reported.

Williams County has nearly half the state’s cases with 13 infections, according to Health and Human Services.

The state has reported 23 cases in people who are less than 20 years old, including three in children 5 years old or younger.

Burke is the fourth county in North Dakota to have a measles case. Cass and Grand Forks counties reported seven cases each as of Thursday. At the end of last week, Cass County reported six cases and Grand Forks County reported two.

People in Divide County may have been exposed to the virus, Health and Human Services said. Places of possible exposure in Crosby include Lindsey’s Grocery Store at 211 Main St. S. from 3 to 5:30 p.m. Monday and Dollar General, 1108 Fourth St. SE, between 3:20 and 5:45 p.m. Monday, the release said.

“This is the highest number of measles cases reported in North Dakota since 1978, when 211 cases occurred,” state Immunization Director Molly Howell said in a statement.

North Dakota has a vaccination rate of almost 90%. The risk of measles to vaccinated residents is low, Health and Human Services said.

Measles is highly contagious since it can spread through the air and linger in rooms for up to two hours, the release said.

“People with measles are contagious before and after symptoms appear, increasing the risk of unintentional spread,” the release said.

The state recommends two doses of the measles, mumps and rubella vaccine — the first between 12 and 15 months old and the second between 4 and 6 years old.

Two doses of the vaccine provide 97% protection, while one dose is 93% effective, according to the Centers for Disease Control and Prevention. The MMR vaccine is effective for life.

Residents who were born before 1957 are considered immune.

Those who have contracted the virus should monitor symptoms for 21 days, while unvaccinated people who are exposed to measles should quarantine for the same time period, the release said.

Information on measles and the vaccine can be found at

hhhs.nd.gov/immunizations/measles.