LANSING, Mich. (AP) — Health officials are urging people to get vaccinated and take other precautions after confirming 15 cases of measles in Michigan this year.

The Michigan Department of Health and Human Services gave an update Friday, saying it’s the highest level the state has seen since 1994 when 26 cases were reported.

Earlier this week, the Oakland County Health Division said two Oakland County residents with the disease arrived on a flight at Detroit Metropolitan Airport in Romulus the evening of Oct. 23.

Health officials note measles is a highly contagious illness and vaccinations are an effective way to prevent it. Measles typically will start with a high fever, red eyes, runny nose, sensitivity to light, and eventually rashes on the face and head that progresses to other parts of the body.