Minnesota has confirmed 36 cases of measles so far in 2024, making it the second-worst year for the highly infectious and vaccine-preventable disease in the past quarter century.

Most cases are among unvaccinated children in the state's Somali community, a statement from the Minnesota Department of Health said Wednesday. While anyone is at risk if unvaccinated, the state raised special concern for Somali residents ahead of group events next month and the start of school.

"Vaccination offers the best protection," said Dr. Ruth Lynfield, the state's epidemiologist.

Since 2000, Minnesota has only seen one larger measles outbreak — a 2017 cluster of 75 infections linked to children in Twin Cities child-care facilities.

State health officials raised concerns in July, because three measles cases had been reported among children in Anoka, Hennepin and Ramsey counties who had no apparent connections.

Epidemiologists now suspect they had contact with other children who contracted measles earlier in the year as a result of overseas travels to countries where the disease is widespread. The three July cases then spread measles to friends, relatives or other children attending the same child-care facilities, according to the health department.

Pediatricians on Wednesday said they encouraged Somali parents to vaccinate their children and to overcome the misperception that the vaccine increases the risk of autism.

"Vaccination rates against measles have dropped significantly in our Somali community ... yet the number of autism cases have not decreased," said Dr. Abdul Abdi, a pediatrician at Children's Minnesota. "This clearly demonstrates that there is no link between the MMR vaccine and autism."

The measles virus can linger in the air for up to two hours, presenting an infection risk even after an infected person is no longer around. The disease often begins with cold and fever symptoms and a characteristic, itchy rash that spreads from the head to the rest of the body.

About a third of the cases this year have required hospitalization. One has involved an adult.

The start of school raises the risk of spreading the virus, along with the Islamic Association of North America Annual Convention on Sept. 1 and the Minnesota Muslim Convention on Sept. 14. Health officials urged unvaccinated people to avoid these events if they may have been exposed to measles.

"We want the health and safety of all of those attending, and our broader community, to be a top priority," said Sheikh Yusuf Abdulle, executive director of Islamic Association of North America.

Vaccine hesitancy has been a growing problem, beyond Minnesota's Somali community, since the COVID-19 pandemic. The share of kindergartners in Minnesota who are up to date with the measles, mumps and rubella shots has fallen from nearly 93% in 2020 to 87%.