Dr. Richard Leman of the Oregon Health Authority discusses vaccinations and the Vancouver-area measles outbreak. Posted by The Oregonian on Tuesday, January 22, 2019

A precautionary warning that someone with measles visited Bend has been confirmed, tied to the Clark County outbreak. That case helped bump the total number of people with measles up to 38 on Wednesday.

The number of suspected cases also continues to grow with 13 people who have the symptoms of measles awaiting the result of blood work.

The new cases are children, as the vast majority of all the people infected since Jan. 1 are.

The Bend connection shows the reach of the measles outbreak. One person in King County, Washington, got measles after a trip the Vancouver area. Two children from Clark County who visited Hawaii were quarantined there when they came down with the disease.

One person in Multnomah County also has measles linked to the Clark County outbreak.

Clark County Public Health Officer Alan Melnick said his office has only started to analyze the cases to try to pinpoint an origin for the outbreak. Melnick said he cannot say how the outbreak began or ended up in Clark County -- and that in some outbreaks that is never known. But he did confirm that the cases so far are widespread and the infected region is expected to grow.

The highly contagious virus spreads through the air and can linger for up to two hours in an isolated space. People who have never received a measles vaccine are susceptible to the disease, which can be deadly.

The measles vaccine is 97 percent effective and can reduce the risk of infection if gotten within 72 hours after exposure to the virus.

A trampoline park and a fitness center were flagged by Deschutes County as possible sites people might have been exposed to the measles virus and on Wednesday, Clark County Public Health added them to the official list.

The public health department has spent nearly $187,000 so far on investigating and limiting the spread of the outbreak.

To further limit the spread of the virus, health officials ask that people who think they might have measles call their doctor or health care provider before visiting a hospital or doctor’s office.

Washington State Department of Health keeps track of residents’ immunization status so people can see if they need shots.

Clark County Public Health also now maintains a daily call center for questions about the outbreak at 360-397-8021.