A measles outbreak is continuing to spread in Merseyside.
Wirral has so far been in the clear - but now health officials say there is one confirmed, two probable and 12 possible cases.
The majority of patients affected in the outbreak are in Liverpool, where there are 25 confirmed, 25 probable and 32 possible cases.
A team of specialists from the Health Protection Agency (HPA) and local NHS services is now investigating 48 laboratory confirmed cases, 37 probable cases and 108 possible cases.
The majority of the cases are in children under the age of five who were not vaccinated at the optimum age of 13 months and babies and toddlers who are too young to be vaccinated.
A small number of adults have also been affected.
Dr Roberto Vivancos, a consultant with the HPA’s Cheshire and Merseyside Health Protection Unit, said: “Measles is highly infectious and unvaccinated children are at risk when it gets into a community.
"Furthermore, when unvaccinated older children pick up an infection they can pass it on to vulnerable infants who are too young to be vaccinated.
"That would appear to be what’s happening in this outbreak.”
The HPA advice to children and adults with measles is to:
Avoid contact with others, particularly pregnant women and infants as they are more vulnerable to infection and measles is highly infectious.
Stay away from schools, nurseries and work places until at least four days after the onset of the rash.
Telephone the family GP for advice before attending GP surgeries, NHS walk-in centres or hospital Accident & Emergency units so arrangements can be made in advance for minimising the measles patient’s contact with others who may be more vulnerable to infection.
Information on measles is available online by clicking the links below.
Advice is also available from NHS Direct by telephoning 0845 46 47.