Costa Rica is enacting a National Surveillance Protocol after confirming two cases of measles, the Health Ministry announced Thursday afternoon.

The Health Ministry had announced four suspected cases earlier Thursday and had sent specimens to labs for confirmation.

The symptoms were reported in children aged between 3 and 10 years old in Cóbano, Puntarenas, the Health Ministry said in a statement. The children were not vaccinated against measles by their parents, who are United States citizens, the Health Ministry said.

The Health Ministry believes the virus was imported to Costa Rica by a United States citizen who left the country March 12.

“There will not be an epidemic of measles in our country,” said Daniel Salas Peraza, the Minister of Health, citing the country’s vaccination initiatives. “But obviously, we don’t want any child to suffer from measles or face the complications measles can cause.”

The children displaying measles symptoms are part of a family with nine children and remain under strict quarantine, the Health Ministry said. The organization is determining who the family may have come in contact with to decide what additional preventative measures are needed.

“All parents whose child exhibit symptoms that could be measles […] should consult medical assistance immediately to determine if it’s measles and to take necessary measures,” the Health Ministry said.

The Health Ministry believes there is no relationship between the four suspected cases and the French family that reintroduced measles to Costa Rica last month. Those cases, Costa Rica’s first since 2014, also involved an unvaccinated child.

“There is a vaccine at one year, three months and another upon starting school, and they are essential to prevent measles in the country,” the Health Ministry said.

Measles is a highly contagious virus that lives in mucus and can spread through coughing and sneezing. The virus can also survive for two hours in an airspace where the infected person has coughed or sneezed, according to the Center for Disease Control (CDC).

The CDC estimates measles killed 500 people annually in the United States before a vaccine was developed in 1963.

The CDC recommends “all children get two doses of MMR (measles-mumps-rubella) vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age.”

This story was updated at 4 p.m. with confirmation of measles from the Health Ministry.

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