Pennsylvania state health officials report 13 additional confirmed measles cases since Friday, bringing the total in the state to 903.

Counties reporting the most cases include Lancaster County (363), Mifflin (106) and Chester (83).

176 hospitalizations have been recorded and there has been four measles-associated deaths.

Health officials remind the public that measles is very contagious. Measles can cause serious health complications, especially in children younger than 5 years of age. Serious complications include pneumonia and encephalitis.

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In addition, the best protection against measles remains getting fully vaccinated. The MMR vaccine, administered over two doses, boosts a person’s immune system and provides 97% lifetime protection.