The state's measles cases have spread from north-central Ohio to southwestern Ohio, a development that has state health officials worried that an already fast-moving outbreak is spinning out of their control.
Huron County Health Commissioner Tim Hollinger said no cases have been reported in Huron County. Local doctors or hospital officials would report cases to the department.
As a precaution, county health officials have been vaccinating the southern portion of the county's Mennonite population. Hollinger said the measles have been spreading in the Mennonite and the Amish populations.
"That's why we want to get down to our population and get as many of them vaccinated as we (can)," Hollinger said.
Hollinger added his department has been providing vaccines to that population ever since the outbreak started about a month ago.
The vaccine also is available at the health department, 180 Milan Ave., Norwalk, for those who haven't been vaccinated and don't have means to pay. If the person has private insurance, county health officials will bill the company, Hollinger said. Call 419) 668-1652 and wait for a prompt for the medical division.
The vaccine is being provided by the Ohio Department of Health. People can call their pediatrician's office if they don't recall whether they received a vaccine, Hollinger said.
"Those are permanent records."
If you've been vaccinated once, you don't need to be again, he said, if you've had the measles, that serves as your body's own immunity to the condition.
Counties affected by the outbreak are Ashland, Coshocton, Holmes, Knox, Richland, Stark and Wayne. More than half the cases are in Knox County.
As of Friday, 397 cases of measles had been reported nationwide. The last time the year-to-date tally was higher was in 1994, when there were 764 cases.
"Unvaccinated people or parents with infants too young to be vaccinated should consider not traveling to areas where measles outbreaks are occurring," said Mary DiOrio, state epidemiologist with the Ohio Department of Health.
The worrisome case involves a 6-month-old Amish girl in Highland County who traveled with her family last month to one or more counties where 297 people were infected as of Tuesday, according to the Ohio Department of Health.
The case still lacks confirmation by the federal Centers for Disease Control and Prevention, but is "more than likely measles," said Highland County Health Commissioner Jim Vanzant. The two-dose measles, mumps and rubella vaccine is not given to children younger than 1 year.
Measles symptoms usually appear seven to 18 days after exposure and include a fever followed by a cough, a runny nose and a red, blotchy rash on the face that spreads down the neck and body over several days. The disease is most contagious four days before and four days after the rash appears and can be deadly for babies and young children.
Measles cases are at a 20-year high in the United States, driven largely by the outbreak among unvaccinated Amish populations in Ohio.
"There are several Amish communities in and around Highland County. ... (Measles) will probably be a problem there," said Melanie Amato, spokeswoman for the Ohio Department of Health.
On Monday, the health department dedicated more people to the outbreak investigation, including liaisons to work with county health departments, said Sietske de Fijter, chief of the Bureau of Infectious Diseases for the state.
That day, Gov. John Kasich also signed an emergency order allowing pharmacists to administer the MMR vaccine to people 18 years or older.
Vanzant said the Highland County Health Department holds immunization clinics every Monday that include the MMR vaccine. And mobile clinics visit sites throughout the county, including Amish communities, four times a month.
"If you're not immunized, you're probably going to get (measles)," Vanzant said.
Jessica White of The Columbus Dispatch (MCT) and Reflector staff writer Aaron Krause contributed to this story