The statewide total of confirmed measles cases has reached 1,360 across 44 counties.

Berks County remains at seven cases in the update issued Monday by the sate Department of Health.

The state continues to report five measles-associated deaths.

A department spokesperson said the measles-associated death of a 39-year-old woman announced by the Franklin County coroner on Oct. 12 is still under investigation by department experts.

The department’s update noted the following:

• New positive cases since Oct. 23: 22

• Total counties: 44

• Total cumulative cases: 1,360

• Total hospitalizations: 258

•  Total confirmed measles-associated deaths: 5

• Measles cases among vaccinated individuals: 4 (less than 1% of cases)

According to the department’s dashboard at pa.gov/measles, Lancaster County remains at the top in cases with 478.

Cases in the region: Chester County, 93; Lebanon County, 21; Schuylkill County, 7; Montgomery County, 3; and Lehigh County, 2.

State health center staff have administered almost 6,700 measles, mumps and rubella (MMR) vaccinations at 228 pop-up vaccination clinics in affected communities since the outbreak began in late April, officials said.

Overall, the department has given more than 10,300 MMR vaccine doses this year.

Officials said healthcare providers continue to see an increase in residents interested in the MMR vaccinations. Providers typically administer about 25,000 doses of the vaccine a month. They said more than 56,000 doses were given in September and that more than 39,000 MMR vaccines were given in the first three weeks of October.

Because measles continues to spread, the department said it recommends an additional early zero dose for infants between the ages of 6 and 11 months who live in or travel to counties flagged on the measles dashboard for sustained community transmission. They said the early dose does not replace the two routine doses. Children 12 months and older who have not received any dose should get one now and a second dose at least 28 days later.

Those who have two documented doses of MMR do not need another, the department said. Adults who have only one dose or cannot find their vaccination records should talk with a healthcare provider or pharmacist about getting vaccinated.

Measles is spread when someone who is infected breathes, coughs or sneezes. The virus remains infectious in the air and on surfaces for up to two hours after the infected person leaves the area, the department said.

Symptoms begin with fever, cough, runny nose, and red, watery eyes (conjunctivitis), followed by a rash that starts on the head and spreads downward.

Without proper protection or supportive care, measles can be deadly, officials said. Symptoms can start seven to 21 days after exposure.

If you believe you were exposed to measles and are experiencing symptoms, you are advised to contact your healthcare provider or call the health department’s hotline at 877-PA-HEALTH (877-724-3258).