The measles outbreak in the Hudson Valley continues to rise at alarming rates and is now the largest outbreak in the state in decades.

Officials from Rockland County are now confirming 68 cases of the measles in Rockland, with another 11 being investigated, NBC reports.

In early November, Hudson Valley Post reported 40 confirmed cases of measles. In alerts prior it was 33 confirmed cases and  11 confirmed cases.

Last month, it was reported an international traveler with measles visited multiple locations in Rockland and Westchester counties. Among the locations infected with measles was the Costco in Nanuet and Westchester Medical Center.

Health officials told many Rockland County schools to keep all unvaccinated or under-vaccinated students home from school until 21 days have passed from the last confirmed measles case.

Measles is a highly contagious respiratory disease caused by a virus that is spread by direct contact with nasal or throat secretions of infected people. People first develop a fever, then often a cough, runny nose and watery eyes, followed by an appearance of a rash. People are considered infectious four days before to four days after the appearance of the rash.

Symptoms include a fever, rash, cough, conjunctivitis or a runny nose. Symptoms usually appear 10-12 days after exposure but may appear as early as 7 days and as late as 21 days after exposure.