The Hawaii Department of Health on Tuesday warned travelers to be on alert for measles “as international outbreaks around the Pacific and elsewhere continue to increase.”

There were four reported cases of travel-related measles in Hawaii this year including three visitors and one resident, according to a DOH press release.

“Measles is very contagious and can be serious,” said DOH. “It is spread through the air when an infected person coughs or sneezes. Persons most at risk for catching measles are those who are not vaccinated.”

More: “Possible serious complications include pneumonia, inflammation of the brain (encephalitis), and death. The risk of complications is highest in children who are less than a year old, pregnant women, and persons who have a weakened immune system.”

Measles symptoms usually start two weeks after exposure and may include:

• high fever
• cough, runny nose, and red, watery eyes
• rash

The best way to prevent measles is to get vaccinated with the measles-mumps-rubella (MMR) vaccine.

Health Director Bruce Anderson said, “Infectious diseases are just a plane ride away, and vaccination is the best defense against these life-threatening diseases.”

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