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COLUMBUS, Ohio (WJW) — Columbus Public Health is asking for support from the Centers for Disease Control and Prevention after reporting six more cases of measles in Central Ohio, increasing the total to 24.

A high majority of the 24 cases are in children younger than age 5 with one 6-year-old, per CPH. All of the confirmed cases are in children who are unvaccinated and spread among nine daycare centers and two schools. At least nine of those children have been hospitalized.

CPD health commissioner, Mysheika Roberts, said the increase is an emergency for any individual who is not vaccinated.

“We are actively doing case finding and trying to figure out the connection,” said Roberts. “I can tell you that we have asked for assistance from the federal government, specifically the CDC and we hope to have a final answer in the next 24 hours or so but we anticipate them coming to Columbus to help us with this investigation in the very near future.”

On Wednesday, health authorities reported 18 children were infected with measles from seven daycare centers and one school in central Ohio. Last week, the first four measles cases were confirmed from an unspecified childcare center in the city.

Measles is a highly contagious virus transmitted through coughing and sneezing. According to the CDC, infected individuals can spread the virus for up to four days before becoming symptomatic. It typically takes 8 to 12 days after exposure for symptoms to develop, according to both public health agencies.

The CDC recommends all children receive two doses of the MMR vaccine, with the first between 12 and 15 months old and the second at 4 through 6 years of age or at least 28 days after the first dose.