Confirmed cases of measles continue to rise in the Hudson Valley at alarming rates.

Since October there have been 209 confirmed cases of measles in New York State. 145 cases come from Orange and Rockland counties with 64 cases found in Brooklyn, CNN reports

On Wednesday, health officials from Rockland County confirmed 130 cases of measles.

The outbreak, which started around October, is considered the worst measles outbreak New York has seen in decades.

Since the outbreak, over 14,000 New York children have been vaccinated while over 6,000 unvaccinated children have been kept out of school for over two months, health officials tell CNN.

In October, it was reported an international traveler with measles visited multiple locations in Rockland and Westchester counties. Among the locations infected with measles was the Costco in Nanuet and Westchester Medical Center.

The Rockland County measles outbreak spread into Orange County in November. Health officials in Orange County later warned that a taxi was exposed to measles. 

Around Thanksgiving, shoppers at the Palisades Mall were potentially exposed to measles. 

Measles is a highly contagious respiratory disease caused by a virus that is spread by direct contact with nasal or throat secretions of infected people. People first develop a fever, then often a cough, runny nose and watery eyes, followed by an appearance of a rash. People are considered infectious four days before to four days after the appearance of the rash.

Symptoms include a fever, rash, cough, conjunctivitis or a runny nose. Symptoms usually appear 10-12 days after exposure but may appear as early as 7 days and as late as 21 days after exposure.