In a letter shared with First Coast News Tuesday night, Jacksonville Chief Health Officer Dr. Sunil Joshi confirmed there have been five cases of measles confirmed in Duval County.

The fifth case had not yet been reported on the Florida Department of Health’s online dashboard.

In an interview with First Coast News, Dr. Joshi said the letter was sent to medical providers throughout the community, along with the Duval County Medical Society and the North Florida Pediatric Society.

Joshi said the city is considering this an outbreak, and recommends all healthcare personnel receive two doses of the MMR vaccine at the appropriate interval.

“Vaccinations do work. 93% effectiveness rate with just one dose, but with two, it’s up to 97%,” Joshi said. “And so then, if your child is in a school where there’s a measles case, you would be much, much less concerned about your child if they were fully vaccinated, and that also helps to mitigate the spread of this highly contagious virus.”

Joshi said the five cases were all in young children, and four of them were connected. At this time, it is unknown whether the fifth case is connected or not.

The Centers for Disease Control (CDC) defines a measles outbreak as three or more cases that are related.

In the letter, Joshi strongly encourages facilities to display signage outside emergency departments, urgent care facilities, and clinic entrances telling patients with rash and febrile illness to remain outside and request initial medical evaluation prior to entering the facility.

“The Department of Health here in Duval County has done an amazing job at contact tracing, finding people who may not have been vaccinated or immunized, who are exposed to these cases, isolating them appropriately, and staying in constant communication,” Joshi said in the interview. “And so I do feel like we’re moving in the right direction when it comes to this particular outbreak, but that doesn’t mean there wouldn’t be another one in a few weeks or a few months even, because that’s the nature of this particular virus.”

He said if you start to notice symptoms, the first thing you should do is call your healthcare provider.

The goal, Joshi said, is to keep people who are not acutely ill out of the emergency room, so that it doesn’t spread to other people who may be there for unrelated reasons.