The state Department of Health has confirmed four additional measles cases on Maui and Kauai, bringing the total number of confirmed cases to seven.

Last week, the DOH reported the initial three cases — one on Maui and two on Kauai, with each involving unvaccinated young adults who recently traveled either to the Philippines or Indonesia and Malaysia.

In a news release issued Thursday, state epidemiologist Dr. Sarah Park said, "We are very concerned. These additional cases are an example of how contagious this disease is and how quickly it can spread."

Staff are working closely with healthcare providers and facilities as well as the Center for Disease Control and Prevention’s Honolulu Quarantine Station to identify those who may have been exposed and to make sure they have treatment and are being monitored, Park said in the release. 

Measles is highly contagious, infecting 90 percent of the contacts who are not immune to the disease. Symptoms generally begin about 14 days after a person is infected. The health department said the best way to prevent measles is to get vaccinated. 

Symptoms of measles include: blotchy red rash, fever, cough, runny nose, red and watery eyes (conjunctivitis), malaise, and tiny white spots with bluish-white centers found inside the mouth. 

For more information, go to http://health.hawaii.gov/docd/home/imm/.