The measles outbreak that emerged in February in upper Manhattan and the Bronx has spread to the Lower East Side, and the latest tally counts 25 confirmed cases of the contagious virus, including five new cases -- three children and two adults -- in the last three weeks, the Health Department said.
The latest cases put the total at 12 children and 13 adults.
The initial cases were in Inwood and Washington Heights in Manhattan, and in High Bridge, Morrisania and the Central Bronx, health officials say. At least one case was later confirmed in Brooklyn; three of the most recent cases were identified on the Lower East Side.
Authorities urge vaccinations for those older than 12 months who haven't had them.
Officials investigating the source of the outbreak are looking into whether it could have spread through exposure at medical facilities, including emergency rooms and doctor's offices.
Dr. Jay Varma, the health department's deputy commissioner for disease control, said last month the outbreak may have spread because workers in those medical facilities didn't recognize the symptoms quickly enough to isolate patients and prevent them from spreading it to others.
Varma didn't specify any facilities where lapses may have occurred. He said exposure in such places was common, but since the outbreak wasn't localized to any specific group of people, it may be more challenging to contain.
In a statement Tuesday, Health Commissioner Mary Bassett urged people who suspect they may have the virus to contact their medical provider before going to a doctor, urgent care center or emergency room to avoid exposing others. Bassett also advised health facilities to educate staff about isolation protocol in suspected measles cases.
Measles is a viral infection characterized by a generalized rash and high fever, accompanied by cough, red eyes and runny nose, lasting five to six days. The illness typically begins with a rash on the face and then moves down the body, and may include the palms of the hands and soles of the feet.
As many as one in three people with measles develop complications, which can be serious and may include pneumonia, miscarriage, brain inflammation, hospitalization and death. Infants, people who have a weakened immune system and non-immune pregnant women are at highest risk of severe illness and complications.