With Kansas already seeing an unusual outbreak of mumps, health officials confirmed the state's first cases of measles in more than five years.

The Department of Health and Environment announced Thursday that its lab had identified four measles cases in Harvey County, all in people under 21. County officials said they don't know whether the three cases are related.

The last confirmed measles cases were in 2000, when two people had the disease. There have been four cases in the 10-year period from 1995 to 2005. Children are supposed to get two doses of the MMR vaccine to fight mumps, measles and rubella — one before they are 18 months old and a second before they enter school.

"It's very possible that we will see more cases because this is a contagious illness," said KDHE spokeswoman Sharon Watson. "Measles is much easier to transmit than mumps."

Watson said the department still is investigating whether the latest measles victims had received both MMR vaccines. As with the mumps outbreak, it's possible the measles victims were properly vaccinated.

"There is a small percentage of people who get vaccinated who do not respond to the vaccine," Watson said. "No vaccine is 100 percent effective."

As of Thursday, the state had seen 434 reported or probable mumps cases this year in 43 counties. Typically, Kansas sees only a few mumps cases each year; there were none in 2005. The outbreak has been widespread in the Midwest, with Iowa reporting almost 1,500 cases this year as of Monday.

However, officials and public health advocates have worried about Kansas' relatively low vaccination rates for years.

A report issued last month noted that in 2004, Kansas ranked 43rd among states in the percentage of children under 3 who have received proper vaccinations, at less than 78 percent. The report was commissioned by a new public-private effort to boost vaccination rates.

State health director Dr. Howard Rodenberg said the measles cases, like the mumps outbreak, show the need for Kansans to check their immunization records. KDHE is recommending that people who have not received two doses of the MMR vaccine or are not sure whether they have receive another dose, even if they are adults.

Measles and mumps are viruses that can be transmitted through the air, when people sneeze or cough. But the measles virus is more contagious.

"You can basically be in a room with someone and get it," Watson said.

Measles typically runs its course in a week, though victims are contagious up to four days before and afterward. Symptoms include fever, a cough, mild itching and eyes becoming sensitive to light, as well as a red rash that starts on the upper body. It can lead to pneumonia, ear infections and encephalitis, which causes brain swelling. In rare cases, that encephalitis then leads to death.