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The Salt Lake Valley Health Department has identified two more individuals who probably have the measles.

Both individuals had apparently traveled out of the country, and both are linked to the Olympus High School teen who has the state's first confirmed measles case since 2005, according to the health department. They are the county's first cases since 1997.

"It means that we need to be vigilant," said the health department's executive director Gary Edwards. "We know that it is now in the community."

Edwards did not release the ages of the two new probable cases. The health department hasn't yet contacted them, but Edwards doesn't believe they were hospitalized.

Their physician, who reported the cases to the health department based on news reports of the first case, said they are connected to the teen and had traveled out of the country. Most measles cases in the U.S. are linked to foreign travel.

Edwards encourages people who believe they or their children have the measles to call ahead before going to a doctor's office or emergency room. Facilities need to take precautions so others aren't exposed.

The health department is also urging residents to determine whether family members are up-to-date on vaccinations.

Also on Friday, two students at William Penn Elementary were sent home from school because they may have been exposed to the measles virus during a visit to Olympus High and have not been immunized. They will be excluded from school activities through April 18.

They were among 170 William Penn students and two teachers who were at the high school on March 31 practicing a play in the auditorium.

The health department says anyone at the high school on that Thursday who wasn't immunized is at risk of having been exposed.

While the infected teen wasn't in contact with the children, he did attend school that day and was contagious.

They were told to go home around noon on Friday, said Granite District spokesman Ben Horsley. In addition, one teacher is seeking her vaccination records before she can return.

"This is a precautionary measure," he said. "This removal of students from school is for those students' safety."

In addition, 32 Olympus students and two staff members were sent home from school Thursday because they weren't fully immunized. However, Horsely said 10 students were subsequently able to prove they had been vaccinated.

On Friday, the school had to find several substitutes, since 25 teachers were seeking their vaccination records.

"It was a little hectic this morning," said Sandy Decker, president of Olympus' PTA. "Just trying to make sure the students [who are] not supposed to be there weren't there, making sure the teachers' rooms had substitute teachers."

She said her daughter was immunized and attended school Friday. "I feel pretty comfortable with what's going on," Decker said.

Anyone in contact with an infected person who wasn't immunized is being asked to voluntarily quarantine themselves — no school, church, work or shopping. If they do that, measles shouldn't spread far, Edwards said. "It depends on us as a community keeping it right here."

The infected student is also under a voluntary quarantine.

Health officials recommend that children receive two doses of the measles vaccine, the first by 15 months and the second before they start school at 4 to 6 years old. Because of the measles cases, the health department will vaccinate children as young as 6 months old who have been exposed to the virus.

Primary Children's Medical Center, where the infected teen sought treatment this week, is on the lookout for more cases.

"We have heightened our surveillance," said spokeswoman Bonnie Midget. "Because measles is not commonly seen, we wanted to make sure all of our staff was aware there has been a case and they're specifically looking for any symptoms."

She said emergency room patients with measles symptoms — which include a cough, fever, runny nose, watery eyes and later a rash — will be isolated.

"We wouldn't want them sitting out in the waiting room if there is any possibility," she said.

Officials are also investigating measles cases in Texas, Minnesota and Florida.

In Minnesota, officials have linked 13 cases of the measles to a 2-year-old who developed a rash after returning from a trip to Kenya. At least 11 of the sick had not been vaccinated: five were too young and six weren't due to parental concerns about the vaccine's safety.

In Utah, children attending public schools are required to be vaccinated, but parents can exempt them for religious, medical or personal reasons.

Some parents have delayed or eschewed the measles, mumps, rubella vaccine because of fears that the vaccine causes autism, though the link has been debunked. Still, 97 percent of school-age children in Utah have received two doses of the vaccine.

Adults born before 1957 don't need to be immunized because most had measles as children.

Measles is passed in respiratory droplets from coughing or sneezing or direct contact with secretions of an infected person.

Symptoms start about 10 days after exposure and initially resemble a cold, including a cough, a fever of 101 degrees or greater, runny nose and red, watery eyes. A rash starts a few days later and typically spreads from the face to all over the body. An infected person is contagious three to five days before the rash appears and at least four days after.

About 30 percent of people with measles will develop complications.

According to the Centers for Disease Control and Prevention, 10 percent of children with measles will develop an ear infection; one in 20 gets pneumonia. And for every 1,000 children who get measles, up to three will die.

One case of measles, which is highly contagious, is considered an outbreak. About 90 percent of the people who come in contact with an infected person will develop measles if they haven't been immunized.

hmay@sltrib.com How measles spreads

Measles is passed in respiratory droplets from coughing or sneezing, or direct contact with secretions of an infected person. Symptoms start about 10 days after exposure and initially resemble a cold, including a cough, a fever of 101 degrees or greater, runny nose and red, watery eyes. A rash starts a few days later and typically spreads from the face to all over the body. An infected person is contagious three to five days before the rash appears and at least four days after. —

More about measles

See how the disease is spread and how to spot symptoms. › B3