More measles cases reported in Orange

The three children and one adult are in addition to one child who was diagnosed last week. The children are all 9 to 11 years old, with three attending Emerson Waldorf School in Chapel Hill and the other attending Grady Brown Elementary School in Hillsborough, officials said.

Officials said they don't believe the children were exposed to the disease at school.

All of the new cases are among the contacts with the initial case in the county, and they were already in quarantine and will remain isolated at home, officials said.

Fourteen measles cases have been diagnosed statewide in recent weeks, with a separate outbreak in Stokes County.

Measles is a highly contagious disease that is spread through the air by coughing and sneezing. It also can be transmitted through contact with secretions from the nose or mouth of an infected person.

Initial symptoms may include fever, runny nose, watery red eyes and cough. After a few days, a rash appears on the head and spreads over the entire body.

Measles can be prevented by the combination MMR (measles, mumps and rubella) vaccine. It is important for all individuals 12 months of age and older to be vaccinated.