Nationwide cases of measles grew to 387 this week, which represents the largest number since the 1990s.

Six outbreaks have been reported in New York, New Jersey, Washington and California. The Centers for Disease Control and Prevention defines an outbreak as three or more confirmed cases.

Individual cases have been confirmed in 15 states, though Georgia is the only Deep South state reporting a case of measles.

Local school officials this week said they are not overly concerned about a measles outbreak here. Both Athens City Schools Superintendent Dr. Trey Holladay and Limestone County Schools Superintendent Dr. Tom Sisk said both systems follow state guidelines for immunizations.

Both men also acknowledged the guidelines provide for religious and medical exemptions.

“We constantly concern ourselves with our students health and well-being. The recent outbreak lends to this perspective, but it does not cause us to take any different procedures or precautions than we normally would have on a day-to-day basis,” Holladay said. “We are just more conscious about this particular medical issue.”

Sisk said his office had received a call regarding immunizations as they pertained to religious exemption, but otherwise he wasn’t aware of any heightened concern from parents.

He explained medical exemption forms can be obtained from a licensed physician, while the county health department issues religious exemption forms.

“We are monitoring the situation,” he said.

According to the United Health Foundation, Alabama is ranked 21st in the nation and tied with Missouri in terms of the percentage of children aged 19 to 35 months who have received the measles vaccine. Tennessee is ranked second, while Georgia is ranked 50th.

To read the Alabama Department of Public Health’s immunization requirements, visit https://bit.ly/2Ifh8Q8.