VANCOUVER, Washington — Nearly 50 cases of measles have been diagnosed in one county in Washington state, almost all among children who were not vaccinated, reports say.

Forty-seven cases in Clark County have been confirmed, with another seven suspected cases, oregonlive.com reports. There also is one confirmed case in King County, according to komonews.com.

Forty-one of the cases involve patients who were not immunized, The Columbian reports. Officials were unable to verify if five other patients had received vaccinations, and one other patient, a child, had just received a single vaccination for measles.

All of the patients are under the age of 18 except for one, who is between the ages of 19 and 29.

The Centers for Disease Control website shows that one dose of the measles vaccine is 93 percent effective and two doses is 97 percent effective. The first dose usually is given to a child at age 15 months, with the second dose from 4 to 6 years of age.

The CDC says from 2001 to 2013, 28 percent of children under the age of 5 with measles were treated in a hospital. The disease, which is spread through the air and very contagious, can lead to brain damage, deafness and death.

There is no link between the vaccine and autism, according to the CDC.