A measles outbreak that began at Disneyland may have spread to others in Orange County, where health officials warned the public Thursday about possible exposure.
Orange County health officials confirmed two more unvaccinated children -- who were all old enough to be vaccinated -- contracted measles between Dec. 15 and Dec. 20 at the amusement park.
On Wednesday, California's Department of Health reported nine confirmed cases of measles, of which one case was in Orange County.
But others could have been exposed to measles at health facilities in the area while the three children were infectious, said Orange County Health Care Agency spokeswoman Nicole Stanfield.
At least three other cases have been confirmed, bringing the county total to six. Of the three recently diagnosed, all are adults; one was unvaccinated, one was partly vaccinated, and one was fully vaccinated. None of the adults were hospitalized, Stanfield said.
"We expect more cases to appear," she said.
The sites where members of the public may have been exposed to measles are all located in Orange and include:
- The emergency department at St. Joseph Hospital on Dec. 30 between 6 p.m. and 11:30 p.m.
- Quest Diagnostics Laboratory on Jan. 3 between 12 p.m. and 1:15 p.m.
- CHOC Children's Hospital fourth floor between 3:40 p.m. on Jan. 1 and 12:45 p.m. on Jan. 2.
- CHOC Children's Hospital's emergency department on Jan. 4 from 10:25 a.m. to 12:50 p.m. and on Jan. 5 from 8:25 a.m. to 12:40 p.m.
Brief interactions with those who have measles offer a low risk of infection, but officials are asking those who were at St. Joseph Hospital, CHOC Children's Hospital and Quest Diagnostics Laboratory in Orange to watch for symptoms from 7 to 21 days after the possible exposure.
Symptoms include a rash, fever, cough and red, watery eyes, according to the Orange County Health Care Agency.
Those who have not had measles or the vaccine are at a higher risk for the disease.
Other measles cases in the state have been reported in Alameda, Riverside and San Diego counties, as well as the city of Pasadena, according to the California Department of Public Health. Two additional park visitors who were diagnosed as having measles live in Utah.
Of those confirmed cases, one was vaccinated for measles, six were unvaccinated, and two were too young to be vaccinated, state officials said.
Measles had mostly disappeared in the United States, but there has been a recent upswing in confirmed cases.
In California, Orange County had a large share of last year's confirmed cases, with 22 of the 62 people diagnosed with measles.
For breaking news in California, follow @MattHjourno.
Copyright © 2015, Los Angeles Times12:12 a.m.: This story was updated to correct Nicole Stanfield's name and to report on the number of confirmed cases.
6:21 p.m.: This story was updated to clarify the timing of the confirmed measles diagnoses.
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