CLEVELAND — At least five states have reported measles outbreaks in 2019, according to the Centers for Disease Control and Prevention. Could an outbreak hit Ohio?

Measles is a highly contagious disease and can lead to serious health concerns.

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“I've taken care of children whose brains are inflamed because they've had measles, they can go deaf because they have measles,” said Dr. Lolita McDavid, medical director of Child Advocacy and Protection at University Hospitals Rainbow Babies and Children.

It's why health experts like McDavid are stressing the importance of getting vaccinated. Several outbreaks have been recorded this year, including in New York, Washington, Michigan and New Jersey. Ohio has not seen an outbreak. But McDavid said it's not out of the picture.

“When the immunization rates get so low, then it's very easy for the disease to get in and get started.”

The vaccination rate in Ohio stood at around 88 percent in 2017, according to the CDC. McDavid says concerns are with areas that have a higher number of individuals who are not vaccinated. In 2014, 383 cases were reported in Ohio Amish communities.

“They had gone to the Philippines to help rebuild after a natural disaster, said McDavid. “They aren't immunized, and they brought it back. You just need one person to come back to the community with it and it spreads.”

So what's recommended? When should you get the vaccine?

The CDC reports children should get two doses of the MMR vaccine. The first dose should be administered at 12 through 15 months of age, and the second dose at 4 through 6 years of age.

What about adults?

“If you're me and you're born before 1957, then you don't have to worry about it,” said McDavid. “You probably have a natural immunity.”

McDavid said for those who are a little younger, they may have only received one dose in their lifetime. If you're a traveler and may be around an area where measles is found, a second dose is recommended.

The CDC reports one dose is about 93 percent effective while two doses move the effective rate to 97 percent.

The best advice if you're not sure about your status?

“If you really don't know, you can go to your doctor and get titers drawn to see if you have immunity,” said McDavid.

The test would help determine if you’ve been exposed to the disease and if you have it.