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Michigan health officials have confirmed that a traveler from Israel who was infected with the measles may have spread the virus while visiting Oakland County March 6-13.

The traveler, who visited businesses, a religious institution and a synagogue, also traveled to New York, which is in the midst of its worst measles outbreak in decades. Measles are spreading nationally, too. In all, 228 measles cases in 12 states have been reported from the start of the year through March 7, according to the Centers for Disease Control and Prevention.

Measles is a highly contagious virus that is vaccine-preventable. It is spread when an infected person coughs or sneezes, and can remain the air where a person coughed or sneezed for as long as two hours.

Measles is so contagious, up to 90% of the people close to an infected person will also become infected if they are not immune through vaccination or previous measles infection, according to the CDC. A person who has the measles may be contagious four days before a rash appears and will continue to be contagious for four days afterward.

Where did the measles-infected person go in Michigan?

The Michigan Department of Health and Human Services and Oakland County Health Division say that people may have been exposed to measles at the following times, dates and locations:

Lincoln Liquor & Rx, 25901 Coolidge Highway, Oak Park: 12:20 to 2:45 p.m. on Friday, March 8

25901 Coolidge Highway, Oak Park: 12:20 to 2:45 p.m. on Friday, March 8 Jerusalem Pizza, 26025 Greenfield Road in Southfield: 11:30 a.m. to 2:30 p.m. Tuesday, March 12, Wednesday, March 13

26025 Greenfield Road in Southfield: 11:30 a.m. to 2:30 p.m. Tuesday, March 12, Wednesday, March 13 One Stop Kosher Market, 25155 Greenfield Road in Southfield: Daily from March 6-13

25155 Greenfield Road in Southfield: Daily from March 6-13 Ahavas Olam Torah Center, 15620 W. Ten Mile Road, Southfield: Daily from March 6-13

15620 W. Ten Mile Road, Southfield: Daily from March 6-13 Congregation Yagdil Torah, 17100 W. Ten Mile Road, Southfield: Daily from March 6-13

17100 W. Ten Mile Road, Southfield: Daily from March 6-13 Yeshiva Gedolah of Greater Detroit, 24600 Greenfield Road, Oak Park: Daily from March 6-13

24600 Greenfield Road, Oak Park: Daily from March 6-13 Kollel Institute of Greater Detroit, 15230 Lincoln Street in Oak Park: Daily from March 6-13

Health officials say additional sites of potential exposure may be identified as more details become available.

What should you do if you may have been exposed to measles?

For anyone who has yet to be vaccinated and was potentially exposed, health officials say getting the vaccine within 72 hours of exposure can limit the likelihood of contracting the disease. In addition, your doctor may provide immune globulin (Ig) treatment, which is effective within six days of exposure to people who are at high risk of developing measles.

At highest risk are unvaccinated pregnant women and people who have illnesses that compromise their immune systems such as HIV and diabetes, and people who are taking medications that weaken their immune systems.

In this photo illustration, a bottle containing a measles vaccine is seen at the Miami Children's Hospital in Miami, Florida. (Photo: Joe Raedle, Getty Images)

Anyone born in 1957 or earlier are considered immune from measles.

If you think you might have been exposed, health officials suggest watching for symptoms for 21 days after exposure. If symptoms develop, it is crucial to call ahead to the doctor's office you plan to visit so precautions can be taken to prevent others from potentially being exposed to measles.

What are the symptoms of measles?

The symptoms of measles generally appear about seven to 14 days after a person is infected, but can appear as long as 21 days after exposure. According to the CDC, measles infections usually start with:

high fever, which can rise above 104 degrees

cough

runny nose

red, watery eyes

About two or three days after respiratory symptoms begin, tiny white spots, known as Koplik spots, often are visible on the gums, roof of the mouth and inside the cheeks.

In addition, a red, raised blotchy rash that usually starts on the face before spreading to the trunk, arms and legs will develop.

“Immunizations are the best way to protect our families and communities from vaccine preventable diseases like measles, particularly in light of recent outbreaks nationally and worldwide,” said Dr. Russell Faust, Medical Director for Oakland County Health Division, in a news release.

Why health experts support vaccinations

The World Health Organization has included vaccine hesitancy, which is the refusal to get immunized for vaccine-preventable diseases, among the top 10 global health threats in 2019.

More: Vaccine debate ignites as measles outbreak threatens Michigan

More: Michigan's hepatitis A outbreak is worst in U.S. What you need to know.

In Michigan, the public health code requires children enrolled in public or private schools, licensed day care centers and preschools to be vaccinated. Kindergartners must have immunizations for diphtheria, tetanus and pertussis, measles, mumps, rubella, polio, chicken pox, and hepatitis B before they start school. Children entering seventh grade must also be vaccinated for meningococcal disease.

Unless there is a medical reason to exempt children from being vaccinated, parents who want to opt out must get a waiver from the county health department to enroll their children in school. They can seek waivers that allow them to skip vaccines if they have philosophical or religious objections.

In Oakland County, about 4.8 percent of schoolchildren got vaccination waivers in 2017, the latest year for which vaccine waiver data was available. In some parts of Michigan, as many as 1 in 10 school-age children have gotten waivers to exempt them from getting a school-mandated vaccine.

That puts them and other unvaccinated Michiganders at risk for contracting potentially life-threatening diseases like measles, whooping cough and mumps, Terri Adams, a registered nurse and section manager for the Division of Immunization at the Michigan Department of Health and Human Services told the Free Press for a previous interview.

"In Michigan, we have seen the highest number of measles cases this past year than we have in 24 years," Adams said, noting the state confirmed 19 in Washtenaw and Oakland counties in 2018.

Where can I get vaccinated for measles?

The combined Measles, Mumps, Rubella vaccine is available through the Oakland County Health Division offices at 1200 N. Telegraph Road, Building 34 East, Pontiac and at 27725 Greenfield Road, Southfield. Many pharmacies and doctor's offices also can provide vaccinations.

The Oakland County Health Division accepts health insurance, as well as Medicaid, Medicare, Vaccines for Children (VFC) program, cash, and credit. VFC offers vaccines at no cost for eligible children. The vaccine is administered in two doses, and each dose costs $71, and there is an additional $7 fee per vaccine.

The Oakland County Health Division says no one will be denied vaccinations because they are unable to pay. A discounted/sliding fee schedule also is available.

Contact Kristen Jordan Shamus: 313-222-5997 or kshamus@freepress.com. Follow her on Twitter @kristenshamus.

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