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February 4, 2019, 10:20 PM GMT

By Shamard Charles, M.D.

An outbreak of measles in southwest Washington is getting worse every day, with the number of cases rising to 50 from Monday, according to state health officials.

Clark County health officials have confirmed 49 cases since January 1st. On January 23, one case was confirmed in King County, home to the state's largest city, Seattle. It is not clear where the King County patient was infected, but he reported that he had traveled to Vancouver, the seat of Clark County, before his diagnosis, health officials said.

As with a similar outbreak among Orthodox Jews in the state of New York, almost all infected people were not vaccinated. Clark County reported that 42 out of 49 patients had not been vaccinated against measles. One patient had received only one of two recommended doses of the vaccine and the vaccination status of six others was unknown, according to the provincial health department.

People may have been exposed to the dangerous disease at more than three dozen locations, many in neighboring Oregon, such as Portland International Airport and the Moda Center, the home of the Portland Trail Blazers. Other possible infection sites in Portland include an Amazon Locker location and stores such as Costco and Ikea.

On January 22, health officials from Clark County declared an emergency for public health.

Dr. Scott Lindquist, a Washington state epidemiologist, said that the state health service sees new cases every day. "This is completely preventable," he said in a statement to NBC News.

He advised families to check their immunization records. "If you are worried, your child may develop measles, call your healthcare provider before going to a medical institution in an effort to prevent the spread of measles to vulnerable people within these facilities," he added.

A sign at the Vancouver Clinic in Washington warns visitors of a measles outbreak in Clark County. Gian Flaccus / Good Medical

Anti-vaccination hotspots have been developing for several years. Together with Washington and New York, at least seven other states – Hawaii, Oregon, Pennsylvania, Connecticut, Colorado, California and Georgia – reported measles cases this year.

Reports that some people use self-medication with vitamin A have also emerged, warning the Washington State Department of Health in a tweet that vitamin A has no effect on measles and that "the only way to prevent measles, is to vaccinate against it. "

Vitamin A can not prevent or cure the measles. For a child with a healthy diet in the US, taking more vitamin A has no effect on their measles disease because they get enough of it. The only way to prevent you from getting measles is against being vaccinated against it. pic.twitter.com/tYUNKNkGUJ

– WA Dept. of Health (@WADeptHealth) January 31, 2019

Children with vitamin A deficiency are at greater risk for serious measles complications when they get the disease, but most children in the US receive adequate amounts in their diet. In the rare case of a deficiency, vitamin A can be used to prevent serious complications of measles, including blindness and death.

Vitamin A is found in many foods, such as spinach, dairy products and liver. It is used as an oral supplement in people with a poor or severely restricted diet or in people with a condition that increases the need for vitamin A, such as pancreatic or eye diseases. It is also used in topical creams to reduce fine wrinkles, stains and roughness and to treat acne.

The recommended daily amount of vitamin A is 900 micrograms for men and 700 for women. Taking too much at once – more than 200,000 micrograms – can cause nausea, vomiting, dizziness, or blurred vision. More than 10,000 micrograms per day can cause long-term damage, such as bone loss and liver damage. Pregnant women are especially warned about taking vitamin A because it has been shown to cause birth defects.

The ongoing eruption and the perceived need for home remedies is a reminder that the herd immunity – the indirect protection of non-vaccinated people that occurs when a large percentage of the population has been vaccinated – has failed.

The measles virus is very contagious. Before the introduction of the vaccine in 1963, there were four million cases of measles in the US each year, with 48,000 hospital admissions and 500 deaths.

The measles-mumps-rubella vaccine has been part of routine childhood recordings for decades and measles were eliminated in the US in 2000. Those who receive the correct doses of the vaccine rarely get the disease, even if they are exposed.

Children usually receive the first vaccine at an age of 1 to 15 months and the second dose at 4 to 6 years. If everyone receives the vaccine with the right doses, the immunity of the herd is reached.

Symptoms of measles generally start a week to 14 days after infection. They include a high fever, cough and the characteristic bluish white rash on the inside of the cheek called Koplik spots. If untreated, encephalitis, a potentially fatal inflammation of the brain, can develop.