Public health officials said Thursday they are tracking a multi-state measles outbreak that has grown to include five infections, including two cases in New Hampshire residents and at least one in a resident of Vermont.
An alert from the New Hampshire Department of Health and Human Services on Thursday warned that people who visited three particular locations earlier this month might have been exposed to someone with the highly contagious infection.
That person, a traveler from out of state, visited Baked and Brewed Café in Alton and Texas Roadhouse in Concord on July 5 in the afternoon, then visited the Common Man in Merrimack on July 6 in the afternoon, according to the announcement.
While that traveler’s state of residence was not immediately clear, the update from New Hampshire officials came as Massachusetts officials announced that state’s first confirmed measles case in four years. The patient, who was diagnosed in early July, is an adult who recently traveled internationally.
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Spokespeople for public health agencies in New Hampshire and Massachusetts did not immediately respond to a request to confirm whether the case in Massachusetts had been linked to the outbreak affecting residents of New Hampshire and Vermont.
The five infections listed in New Hampshire’s updated tally ― which does not specify where the three non-residents are from ― have all been traced to an international traveler who was diagnosed late last month, shortly after returning home from a visit to Hanover, N.H.
New Hampshire officials announced June 28 that the traveler had visited Dartmouth College and local businesses before riding a Dartmouth Coach bus from Hanover to Boston Logan Airport on June 22 to fly home.
Massachusetts officials alerted the public on June 29 that the international visitor who had been in Hanover, N.H., traveled through Boston on public transit during their return trip to Amsterdam on June 22 while infectious with measles. The bus arrived at the airport at about 2:40 p.m., and the traveler was in Terminal E until about 8:40 p.m., officials said.
The number of confirmed cases grew to a cluster of three on July 9, when officials in Vermont and New Hampshire announced that one resident from each state had gotten sick, likely as a result of being exposed to the traveler in the Hanover, N.H., area.
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Those who may be susceptible to contracting measles include people with weakened immune systems and those who have not been vaccinated, including infants who are still too young to receive the vaccine.
Individuals who have received two doses of the measles vaccine are close to 100 percent protected and have close to lifelong immunity, according to Dr. David Hamer, a professor of global health and medicine at the Boston University School of Public Health who also directs a travel clinic at Boston Medical Center.
Symptoms of measles include high fever, cough, runny nose, and watery eyes several days before developing a body rash.
This outbreak comes as cases surge in parts of the United States and Europe. The US reported 13 outbreaks so far this year, compared with four in all of 2023, according to the US Centers for Disease Control and Prevention. In Europe, public health officials have warned that the total number of reported cases was on the cusp of surpassing all recorded cases in 2023. More than half of those who contracted the disease in Europe in 2023 were hospitalized, according to the World Health Organization.
Globe reporter Adam Piore contributed to this report.
Steven Porter can be reached at [email protected]. Follow him @reporterporter.