Another case of measles has been confirmed in New York City, bringing the total number of cases considered part of the outbreak that emerged in February to 26, the Health Department said Wednesday.



The outbreak remains centralized in upper Manhattan, the Health Department said, though cases have been identified in the Bronx, the Lower East Side and Brooklyn. It's not clear where the latest case was.



Twelve children and 14 adults have tested positive for measles so far. An additional case was identified, but the Health Department said it was associated with foreign travel and unrelated to the outbreak.



The most recent case was identified more than two weeks after the last confirmed cases, and the Health Department is urging continued vigilance. Anyone older than 12 months who hasn't been vaccinated for measles should be as soon as possible, authorities say.



Measles is a viral infection characterized by a generalized rash and high fever, accompanied by cough, red eyes and runny nose, lasting five to six days. The illness typically begins with a rash on the face and then moves down the body, and may include the palms of the hands and soles of the feet.



As many as one in three people with measles develop complications, which can be serious and may include pneumonia, miscarriage, brain inflammation, hospitalization and death. Infants, people who have a weakened immune system and non-immune pregnant women are at highest risk of severe illness and complications.



Officials investigating the source of the outbreak are looking into whether it could have spread through exposure at medical facilities, including emergency rooms and doctor's offices.



Dr. Jay Varma, the Health Department's deputy commissioner for disease control, said last month the outbreak may have spread because workers in those medical facilities didn't recognize the symptoms quickly enough to isolate patients and prevent them from spreading it to others.



Varma didn't specify any facilities where lapses may have occurred. He said exposure in such places was common, but since the outbreak wasn't localized to any specific group of people, it may be more challenging to contain.



In a statement Wednesday, Health Commissioner Mary Bassett urged people who suspect they may have the virus to contact their medical provider before going to a doctor, urgent care center or emergency room to avoid exposing others. Bassett also advised health facilities to educate staff about isolation protocol in suspected measles cases.