The Minnesota Department of Health has identified two more measles cases in Minneapolis, bringing the total number of confirmed cases to six this year.
As result, the Health Department says all Somalis 13 months and older in the greater metro area should get their second measles vaccination if they have not already done so.
The agency also recommends that all families in Hennepin County to do the same. The agency believes the measles outbreak started with a Somali child.
Typically parents are told to wait a few years between their child's measles immunizations. But this outbreak has added new urgency to the need for vaccinating the population quickly.
Like the four previous cases, the two newest measles infections occurred in children. One was a baby that was too young to be immunized against measles. The other was a Somali child who had returned to Minnesota from Kenya in early February.
State Epidemiologist Ruth Lynfield believes that child is the source of the Minneapolis outbreak.
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"There is measles circulating in Kenya and the incubation period is right for when the child presented with illness, for the child having been exposed in Kenya," she said.
Measles is a very contagious disease that spreads rapidly among unvaccinated populations.
Half of the cases so far have been in Somali children who were not immunized. Some Somali parents told the Health Department they didn't vaccinate their kids because they were worried that they would develop autism.
Lynfield said in past years Minnesota has had enough of what health officials call "herd immunity" to limit the spread of measles. But she said that's changing quickly as fewer people get their kids vaccinated.
"We had six cases prior to this year, over the past five years," Lynfield said. "And now we've had six cases in a month."
It's not known exactly how many Somali families are skipping the Measles, Mumps and Ruebella vaccine, also known as the MMR. But at the Axis Medical Center in Minneapolis, Dr. Abdirahman Mohamed estimates that as many as 70 percent of the Somalis he knows have not given their children the vaccine.
"Every family will tell you that, 'We're not going to give our children the MMR. We're afraid that they're going to get autism,'" Mohamed said.
Mohamed said he has been going on local radio and television programs for years in an effort to convince his fellow Somalis that there is no link between the MMR vaccine and autism.
"But I think what's needed is a bigger campaign from the state level, from the local level," Mohamed said. "A bigger campaign, because I don't know how many people that we are reaching, whether it is radio or T.V."
The Health Department will meet with Somali leaders Saturday to discuss ways to get their message out to the community. The agency is planning to hold a public forum on the measles outbreak next Saturday.
Zuhur Ahmed, host of KFAI's "Somali Community Link" program, says she will address the measles outbreak and vaccine flap on her show this Sunday. It's a topic she has addressed dozens of times already. "It's just frustrating how much the community is stuck with this notion that [the measles vaccine] causes [autism] and they're really, really misinformed," Ahmed said. "I feel like a greater effort needs to be done to convince them to vaccinate their kids because they stand strongly against vaccination now."
Most people who get measles will recover without serious problems. But as many as a third will develop complications such as pneumonia, encephalitis or a bacterial super infection. Two out 1000 people who contract measles in the U.S. will die from their infection.
The Health Department says four of the six Minnesota children who have contracted measles so far, did require hospitalization. They are all expected to recover.