Costa Rica’s Ministry of Health confirmed on Thursday positive measles cases in two of four American children who fell ill earlier this month.

The ministry tested four children between the ages of 3 and 10 in Cóbano, Puntarenas, who exhibited symptoms of the measles after being treated at a social security clinic in the region. The parents, who are American citizens and have five other children, never had their children vaccinated for the measles.

Costa Rica’s child welfare service, Patronato Nacional de la Infancia (PANI), intervened earlier Thursday and placed the family of 11 under strict quarantine where they live in Cabuya de Cóbano in order to prevent them from spreading the virus.

“The children were treated at the CCSS (Social Security) Cóbano Clinic, have had a fever since March 15 and skin breakouts since the 18th,” the Ministry of Health reported in a press release.

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Costa Rica is putting National Surveillance Protocol in place to determine if additional measures need to be taken to prevent the spread of the virus. The children are suspected to have contracted the virus from an American woman visiting the family who left Costa Rica on March 12.

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

The Ministry of Health is investigating who else the infected children might have come in contact with, but the children have not attended school in the country.

The executive president of PANI, Patricia Vega, explained it is within the child welfare service’s power to force the children to be vaccinated if they determine the children’s rights to health and education are in jeopardy.

“We have already pronounced on our power to force the children to be vaccinated. In this case, what we ordered was that the local office initiate a special protection process, which means that the PANI will visit the family to assess if there are any violation of the rights of the children; in this case, health and education,” Vega told Q Costa Rica.

The Ministry of Health said it does not suspect a link between this case and that of the unvaccinated French 5-year-old who reintroduced measles to the country in February, the first known case of measles in Costa Rica since 2014.

The measles infection in the two American children is the first autochthonous case in Costa Rica since 2006, meaning these children are the first to contract the virus while in Costa Rica in over a decade, reported Q Costa Rica.

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Measles is a highly contagious viral infection that spreads through the air when an infected person coughs or sneezes. The infection begins with a fever, cough, runny nose and red eyes before a rash of tiny red spots breaks out, according to the U.S. Centers for Disease Control and Prevention (CDC).

Data from the CDC said approximately 500,000 cases of measles were reported per year in the United States before the measles vaccination program was launched in 1963. Of the reported cases, 400 to 500 people died and 48,000 others were hospitalized a year. Measles cases dropped by 99 percent since the widespread acceptance of the vaccine.

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