As some areas of the country are experiencing measles outbreaks, defense health officials report that there have been no confirmed cases of measles in 2019 among military members or their families, at least among those treated in military treatment facilities.

Military treatment facilities however, like Naval Hospital Bremerton, Washington, are monitoring the situation. Washington is one of the states with current measles outbreaks. Officials at Bremerton advise those whose children have symptoms of measles to immediately call their medical providers or urgent care clinic before bringing the child to the facility, so that providers can meet the parents in the parking lot, provide a mask for the child and escort the child to bypass the waiting room into the clinic.

Many military family beneficiaries get their medical care through civilian health care providers.

A big reason for lack of cases: all service members are required to get the measles vaccine, and all family members are strongly encouraged to get them.

Children attending Department of Defense Education Activity schools must provide proof of immunization.

According to the Centers for Disease Control and Prevention, from Jan. 1 through April 11, there were 555 individual cases of measles confirmed in 20 states. That’s the second-greatest number of cases reported in the U.S. since measles was eliminated in 2000.

The areas with current measles outbreaks, identified as three or more cases, are: Rockland County in New York; New York City; Washington; New Jersey; Michigan; and Butte County in California. The outbreaks are linked to travelers who brought measles back from other countries, according to CDC.

Measles is spread to others through coughing and sneezing, well before the infected person realizes he or she has the disease. The virus can live for up to two hours in the air where the infected person coughed or sneezed, according to CDC.

Immunization awareness is part of the Defense Health Agency’s April monthly theme, “Military Children’s Health," according to Defense Health Agency spokesman Kevin Dwyer. They published an article online, “Measles vaccine protects against potentially serious illness.”

Measles generally start with high fever, cough, runny nose and red, watery eyes, followed two or three days later with tiny white spots that appear in the mouth, according to CDC. Three to five days after the first symptoms, a rash breaks out, usually as flat red spots that appear on the face and spread downward.

Defense officials follow the CDC recommendations that children should get the first dose of the measles, mumps and rubella vaccine at age 12 to 15 months. The second dose follows at least 28 days later, but usually between the ages of 4 and 6, officials said.

Adults who didn’t get at least two vaccine doses in childhood should also get at least one dose, and those who are uncertain of their vaccination history can get a blood test to confirm they’re protected from measles, or get the extra vaccine dose.

The majority of people who have contracted the highly contagious disease are those who haven’t been vaccinated. Children younger than 5 and adults older than 20 are more likely to suffer from complications from measles, according to the CDC. Those include ear infections, and can result in permanent hearing loss; and diarrhea. Some people may suffer from severe complications such as pneumonia and encephalitis (swelling of the brain.)