A recent outbreak of measles is the latest public health problem among Somalis who live in metropolitan Minneapolis-St.Paul, Minnesota, home to the largest Somali community in the country.

Measles now joins active tuberculosis as a public health problem within Minnesota’s Somali community.

“During the five years between 2010 and 2014, 732 cases of active TB were diagnosed in Minnesota. Of these, 81 percent, or 593, were foreign-born. Of foreign-born cases, 50 percent, or 296, were refugees, according to “The Epidemiology of Tuberculosis in Minnesota, 2010-2014,” a report published by the Minnesota Department of Health,” Breitbart News noted in October.

“Twenty-nine percent of the 593 foreign-born cases of active TB diagnosed in Minnesota [between 2012 and 2015], or 161, were attributed to Somali born migrants. Almost all Somali migrants to the United States have arrived under the federal refugee resettlement program,” Breitbart News reported at the time.

“The Hennepin County measles outbreak grew to 20 cases Monday, after eight new infections were confirmed. State health officials said all the cases have occurred within the Somali-American community, and they urged parents to get the measles vaccine for themselves and their children if they are unvaccinated,” the Star Tribune reported last week:

The outbreak is expected to produce many more cases and could exceed the 2011 outbreak of 26 cases, according to Kris Ehresmann, infectious disease director at the Minnesota Health Department.

So far, all of those who have caught the measles in this outbreak are 5 years old or younger. Exposure has occurred at several day care centers.

Since the first case was detected two weeks ago, health investigators have been trying to identify anyone unvaccinated exposed to the virus, which is highly contagious. It can take up to three weeks for measles symptoms to develop.

“The Health Department recommended Monday that the schedule for a second dose be accelerated for any Somali-American children who had received the initial shot, which they said is a common practice during outbreaks,” the Star Tribune reported:

The eight new infections in this outbreak include for the first time at least one baby under 12 months, an age group that has been of concern to public health officials because they typically lack immunity protection. Investigators have examined the vaccination records of 16 of those infected, and none of them had received the MMR shot. Records for the other four are still being collected. Measles symptoms include coughing, a sore throat, fever and a blotchy skin rash. It can lead to pneumonia and encephalitis, or swelling of the brain, and in same cases is fatal.

“According to a health department official, Minnesota’s Somali immigrant community has been a particular target of the anti-vaccination movement, colloquially known as ‘anti-vaxxers,’ ” Mic.com reported last week:

“They’re very much engaged with and targeting this community,” Kris Ehresmann, infectious disease division director at the Minnesota Health Department, said in a phone call Wednesday. According to Ehresmann, anti-vaccine groups began to target the Somali community around 2008, amid concerns about autism among Somali-American children. Anti-vaccine groups started reaching out to the Somali community and showing up at community health meetings, she said, disseminating misinformation linking autism to the measles, mumps and rubella vaccine, or MMR. Since then, the population has seen a “steady decline in MMR vaccine rates.”

“At least one high-profile figure in the anti-vaccine movement has made special trips just to speak to Somali immigrants. In 2011, Andrew Wakefield, a man who has been called the “father of the anti-vaccine movement,” showed up in Minnesota in the midst of what was then the state’s first major measles outbreak in years, the Star Tribune reported at the time,” Mic.com added.

Ehresmann said that wasn’t Wakefield’s first trip to speak to Somali families in Minnesota — she believes he visited once before, in 2008, when anti-vaxxers were first arriving to spread misinformation. Wakefield, the now-disgraced British doctor who published a widely shared and subsequently discredited paper implying a link between vaccines and autism, traveled to Minneapolis to hold a private forum for Somali immigrants. The meeting was described at the time as a “support group” for families of autistic children, the Star Tribune reported.

Hennepin County is also the site of two recent cases of active tuberculosis at local public high schools, as Breitbart News reported in February:

Another case of active tuberculosis (TB) has been diagnosed in Hennepin County, Minnesota public schools, local officials confirmed on Wednesday.

The new case has been diagnosed in “a person at Central Middle School in Eden Prairie,” KARE TV reports. This marks the second time in two months Hennepin County Department of Health officials have confirmed that a person at a public school in the county has been diagnosed with active TB. In January, Hennepin County Public Health Department officials reported that a person at St. Louis Park High School had been diagnosed with active TB.

The letter to parents from St. Louis Park Public Schools informing them of the case of active TB in January was sent in three languages: English, Spanish, and Somali, Breitbart News reported.