The first reported case of a person with measles in the recent Memphis outbreak, which now numbers seven confirmed cases, was at a local mosque on April 15, according to the Shelby County Health Department.

“The first public place where there was a public exposure potentially [to measles] was the Masjid Al-Noor Mosque on April 15,” Dr. Alisa Haushalter, Director of the Shelby County Health Department, tells Breitbart News.

“The mosque is one location we know that individuals who were infectious were during their infectious period, but that’s not necessarily where the first case occurred. I don’t want you to draw conclusions without sufficient information,” she added.

Haushalter acknowledged, however, that the measles outbreak could have originated with an unvaccinated for measles adult or child brought to Tennessee under the federal refugee resettlement program, something she called “a possibility amongst many.”

There had been no reported cases of measles in Shelby County for the previous 24 months, according to a spokesperson for the Tennessee Department of Health. “There have been nine previous cases of measles in the entire state of Tennessee in the past 12 years,” WREG reported.

The Shelby County Health Department first notified the public of a measles outbreak on Friday morning, April 22, reporting two confirmed cases, an adult and a child.

“We take the testing [of patients for measles] to the state lab then to CDC. We went public as soon as we received the confirmation,” spokesperson Elizabeth Hart tells Breitbart News.

As of May 10, the number of reported cases of measles in Memphis has increased to seven.

According to the Centers for Disease Control (CDC), the number of measles cases in the United States grew from 63 in 2010 to 667 in 2014. It fell to 189 in 2015. That year, “the United States experienced a large, multi-state measles outbreak linked to an amusement park in California. The outbreak likely started from a traveler who became infected overseas with measles, then visited the amusement park while infectious; however, no source was identified.”

Surprisingly, the majority of the more than 70,000 refugees resettled annually across the United States through the federal refugee resettlement program are not required to have been vaccinated for measles prior to their arrival here.

“Refugees being resettled in the United States, unlike immigrants seeking residency, have not been subject to immunization requirements,” according to a Morbidity and Mortality Weekly Report (MMWR) released by the CDC in January 2015.

Kristen Nordlund, a spokesperson for the CDC, tells Breitbart News, “I think you may not be reading the full MMWR, which does discuss a program that CDC set up that requires refugees from some countries to be vaccinated.”

Refugees settled in the United States under the refugee resettlement program arriving from all but six countries — Thailand, Nepal, Malaysia,Kenya, Ethiopia, and Uganda — are not required to demonstrate they have received immunizations, specifically including measles, according to that January 2015 MMWR from the CDC.

Of the 1,601 refugees resettled in Tennessee in fiscal year 2015, 186 were resettled in Memphis, according to a report provided by Catholic Charities of Tennessee, which administers the program in the Volunteer State on behalf of the federal government under the Wilson-Fish alternative program.

Less than one percent of those 1,601 refugees (a total of twelve individuals) were from the six countries (Thailand, Nepal, Uganda, Kenya, Malaysia, and Ethiopia) where refugees are required to be vaccinated for measles as a condition of their entry to the United States.

Of the refugees resettled in Tennessee by Catholic Charities of Tennessee under the federal refugee resettlement program, 1,589 (99 percent) came from countries of origin where the United States government does not require that refugees have measles vaccinations, including 332 from Iraq, 214 from Somalia, 206 from Congo, 393 from Burma, 138 from Bhutan, 57 from Sudan, 47 from Afghanistan, and 31 from Syria.

Breitbart News contacted the Office of Refugee Resettlement, the part of the Department of Health and Human Services responsible for the federal refugee resettlement program, for comment several times over the past two weeks but has not received a response beyond the acknowledgement they had received our original inquiry.

Michael Evans, State Refugee Health Coordinator for the Tennessee Office for Refugees, part of Catholic Charities of Tennessee, the VOLAG (voluntary agency) hired by ORR to operate the federal refugee resettlement program in Tennessee, did however respond to Breitbart News.

“The Tennessee Office for Refugees has not been contacted by the Shelby County Health Department, and has no information beyond what is publicly available through reputable news sources,” Evans tells Breitbart News.

This seems to be a rather curious oversight by the Shelby County Health Department, given that the first instance of potential exposure occurred at a mosque in Memphis likely to be frequented by refugees resettled by Catholic Charities.

Evans did not deny that the vast majority of refugees resettled in Tennessee by Catholic Charities of Tennessee are not required to be vaccinated for measles prior to their arrival in the United States.

He did, however, offer this statement:

I am happy to confirm that a refugee suffering from a measles infection would not be permitted to travel to Tennessee, and our screening program has not detected a person infected with measles. As indicated in the link you provided (and also found here), a majority of refugees begin or complete their MMR series before setting foot on a plane to the U.S. Once in Tennessee, medical providers review the vaccinations that were administered overseas to determine what series need to be completed here. Additionally, in order for a refugee to adjust their status to permanent resident (a step required of all refugees), the refugee must be vaccinated against measles, as required by U.S. immigration law. The Tennessee Office for Refugees—through the federal Office of Refugee Resettlement—provides access to all immunizations required to adjust status.

The Tennessee Department of Health has been reluctant to provide details on the point of origin of the measles outbreak.

“Due to the small number of individuals confirmed with measles in one county, our HIPAA Compliance Office has determined we may not provide any information at this time that could be used to identify an individual. We take our obligation to protect individuals – and to protect population health – most seriously,” Woody McMillen, director of communication and media relations for the Tennessee Department of Health, tells Breitbart News.

According to the Shelby County Health Department, the first visit of a person infected with measles who may have spread the disease to others came at the Masjid-Al-Noor-Mosque between the hours of 5:30 am and 8:30 am on Friday, April 15.

The Masjid Al-Noor Mosque offers “Adult Quran Class” every morning after “Fajr,” the first of five daily prayers offered by Muslims, according to the mosque’s website. On April 15, those classes would likely have begun shortly after 5:00 am.

Breitbart News contacted the Masjid Al-Noor Mosque for comment, but has not received a response.

The second visit of a person infected with measles came at the same location during the same three morning hours the following day, Saturday, April 16.

By Sunday, persons infected with measles visited two additional locations, the nursery at the Collierville United Methodist Church, which is only open on Sundays from 8:15 am to noon, and a Goodwill store located in Millington, Tennessee.

“From my knowledge it was detected at a local doctor’s office. They caught it early on it was an adult, a woman [who was infected with measles] …. No one else from my knowledge who was infected visited our store. I was not here when she [the woman infected with measles] came in [to the store on Sunday morning],” Ashley Brooks, the manager of the Goodwill store in Millington tells Breitbart News.

According to the Shelby County Health Department:

The investigation of the measles outbreak in Shelby County has identified the following locations as sites visited by people with measles during the time when they were infected with measles and could have spread the illness to others. You may have been exposed to a person with measles if you were at the following locations on the dates listed.

In chronological order, these locations are listed as follows:

Masjid-Al-Noor Mosque

3529 Mynders Ave, Memphis TN

4/15/2016 5:30 a.m. – 8:30 a.m.

4/16/2016 5:30 a.m. – 8:30 a..m. Collierville United Methodist Church Nursery

454 W. Poplar Ave, Collierville TN

4/17/2016 9:00am – 12:00pm Goodwill

8059 US 51, Millington TN

4/17/2016 9am – 2pm Parkway Village Church of Christ

4400 Knight Arnold Rd, Memphis TN

4/17/2016 River City Pediatrics

6401 Poplar Ave, Memphis TN

4/19/2016 Yukon Clinic

1355 W. Brierbrook Rd, Germantown TN

4/19/2016 9:45am – 12:45pm Methodist Le Bonheur Germantown Hospital – Emergency Department

7691 Poplar Ave, Germantown TN

4/20/2016 7:00pm – 4/21/2016 3:00am Family Physicians Group PC

8110 Cordova Road, Memphis TN

4/20/2016 10:00am – 2:00pm

4/22/2016 8:00am – 12:30pm Primary Care Pediatrics

9091 Highway 51N, Millington TN

4/21/2016 1:00pm – 6:00pm St. Francis Hospital – Bartlett – Emergency Department

2986 Kate Bond Rd, Memphis TN

4/22/2016 any time after 10:45am to 4/23/2016 3:30 p.m.

“What we listed are public places we know individuals were… however somebody could have been ill, but it may not have been at a public case,” Shelby County Director of Health Dr. Haushalter tells Breitbart News.

Haushalter acknowledged, however, that the mosque was “the first potential exposure in a public place… I am familar with the refugee process and how people come through and how their immunization status is checked. Once they come to the US they have a window [of time] through which.. often they can get immunization.”

Haushalter also acknowledged that “In some cases they are required. I don’t know for measles.”

On Friday May 6, the Shelby County Health Department confirmed a seventh case of measles:

The Shelby County Health Department has received confirmation of a seventh case of measles. According to the Shelby County Health Department, six of those infected were not immunized against measles. We are told the cases are all over the county. The original two cases involved an adult, and the other a child. Four of the cases were connected to each other. Two other cases were connected to each other.

The possibility that immigrants brought to the United States under the federal refugee resettlement program pose a potential health risk to the rest of the population is one of a number of objections raised to the continuation of the program. Other objections include the unfunded mandate financial burden social welfare benefits impose upon states where the refugees are resettled, as well as security concerns that the resettled refugees, many of whom are Muslim, may pose due to possible ties to Islamist terrorist groups or ideologies.

The prevalence of communicable disease among refugee populations is well documented. In January 2016, for instance, a severe outbreak of measles occurred in a refugee camp in Calais, France.

In April, the Tennessee General Assembly declared its intention to sue the federal government over its operation of the refugee resettlement program on Tenth Amendment grounds.