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Q: A Clallam County woman has died from pneumonia caused by measles, health officials said Thursday. The last confirmed measles death in the United States was in 2003. 
  
 A Clallam County woman in her 20s died this year from an undetected measles infection discovered only after an autopsy, state health officials said Thursday. The case is the first confirmed measles death in the U.S. in 12 years. 
  
 The woman was likely exposed to the highly contagious infection at a local medical center during a recent outbreak in Clallam County. She was at the site at the same time as someone who later developed a rash and was determined to be contagious for measles. 
  
 The woman, who had several health conditions and was taking drugs that suppressed her immune system, did not show typical symptoms of a measles infection, Department of Health officials said in a statement. Family members said she had been vaccinated, though they didn’t have documentation. The death was attributed to pneumonia caused by measles, a common side effect of the infection, experts say. 
  
 This is the sixth measles case confirmed in Clallam County and the 11th in Washington state this year. Nationwide, at least 178 people in 24 states and the District of Columbia have been diagnosed with measles this year, according to the Centers for Disease Control and Prevention, including many linked to an outbreak that began at Disneyland in Southern California late last year. 
  
 The last measles death in the U.S. occurred in 2003, CDC officials said. 
  
 The situation highlights the importance of widespread measles vaccination, officials said. Some people, including young infants and people with compromised immune systems, cannot be immunized against the disease or may have reduced immune responses to the vaccine. That leaves them vulnerable to active infections in the community. 
  
 Children should receive two doses of the measles, mumps, rubella (MMR) vaccine, with the first dose between age 12 months to 15 months and the second between ages 4 and 6. Adults born after 1956 who have not had the disease should receive at least one vaccination, health officials advise. ||||| CLOSE A woman died this spring due to a measles infection, which is the first reported measles-related death in the U.S. since 2003. VPC 
  
 This undated image made available by the Centers for Disease Control and Prevention on Feb. 4, 2015, shows an electron microscope image of a measles virus particle, center. Measles is considered one of the most infectious diseases known. The virus is spread through the air when someone infected coughs or sneezes. = (Photo: Cynthia Goldsmith, AP) 
  
 The USA has suffered its first measles death in 12 years, according to Washington state health officials. 
  
 The woman's measles was undetected and confirmed only through an autopsy, according to the Washington State Department of Health. The woman's name was not released, but officials said she lived in Clallam County. 
  
 The woman was probably exposed to measles at a medical facility during a measles outbreak this spring, according to the health department. She was at the hospital at the same time as a patient who later developed a rash and was diagnosed with measles. Patients with measles can spread the virus even before showing symptoms. 
  
 The woman, who died of pneumonia, had other health conditions and was taking medications that suppressed her immune system, the health department said. 
  
 Pneumonia is one of several serious common complications of measles and the most common cause of death from the virus, said William Schaffner, a professor at Vanderbilt University School of Medicine in Nashville. Measles kills one or two children out of every 1,000 infected, according to the CDC. 
  
 It's not surprising that the woman had no obvious measles symptoms; people with compromised immune systems often don't develop a rash when infected with the virus, said Paul Offit, chief of infectious disease at Children's Hospital of Philadelphia. 
  
 The woman's death was a preventable, but predictable, consequence of falling vaccination rates, said Peter Hotez, president of the Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development in Houston. 
  
 Measles has surged back in recent years as groups of like-minded parents have opted against fully vaccinating their children. Last year, 644 people contracted the virus. 
  
 A measles outbreak that began at Disneyland over the Christmas holidays in December spread across the country, including to Washington state. 
  
 So far this year, 178 people have been diagnosed with measles, according to the Centers for Disease Control and Prevention. 
  
 Some states have reacted to the outbreaks by passing laws to require more children to be vaccinated. Both California and Vermont this year repealed exemptions that allowed unvaccinated children to attend school because of their parents' personal beliefs. 
  
 A USA TODAY investigation earlier this year found that Washington's vaccination levels may not be high enough to prevent outbreaks. 
  
 Communities need to vaccinate at least 92% of children to prevent outbreaks, said Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City. 
  
 In Washington state in 2013-2014, one-third of the 1,634 schools with kindergartens had vaccination levels for kindergartners under 90%, USA TODAY found. 
  
 An additional 263 schools did not have up-to-date vaccination records for that school year when the state provided USA TODAY data this February. 
  
 The statewide vaccination rate for the nearly 84,000 kindergartners whose records were collected was 89.5%. 
  
 Before vaccines were available, the disease struck 3 million to 4 million Americans a year, hospitalizing 48,000 and killing 500. 
  
 During the last major measles epidemic, from 1989 to 1991, measles infected 55,000 people and killed 166. The outbreak spurred the CDC to increase the recommended number of measles shots for children from one to two. The measure dramatically cut the number of measles cases, which hovered around 60 a year until recently. 
  
 Measles remains a leading killer of children elsewhere in the world, killing nearly 146,000 in 2013, according to the World Health Organization. 
  
 People with compromised immune systems are at high risk from measles. They often can't be vaccinated. Or, if they are vaccinated, their bodies don't respond in a way that protects them from disease, according to the Washington state health department. 
  
 There are hundreds of thousands of these patients in the USA, and they depend on others around them to get vaccines, Offit said. 
  
 "It's not your right to catch and transmit a potentially fatal infection," Offit said. 
  
 By keeping overall levels of measles low, vaccinated people create a wall of protection that prevents disease among vulnerable people, including babies too young to have received their first shots, said William Schaffner, a professor at Vanderbilt University School of Medicine in Nashville. 
  
 "We are responsible not only for our health but for the health of those around us," Schaffner said. "The only way we can protect them from these disease is if we are vaccinated." 
  
 Pediatrician Richard Pan, a California state senator who championed his state's tougher vaccine law, said the woman's death shows why vaccines are vital. Opponents of the law already have mounted an effort to repeal the legislation, which was signed by Gov. Jerry Brown Tuesday. 
  
 "I'm so sorry to hear about this preventable tragedy," Pan said. "All the more reason we must be vigilant about stopping these deadly diseases now. In my own state, a child is currently in hospice because of a measles complication. This is exactly why the law I wrote needs to take effect." 
  
 Sen Richard Pan, D-Sacramento, left, talks with Jennifer Wonnacott, a supporter of Pan's measure requiring California schoolchildren to get vaccinated, after the bill was approved by the state Senate on May 14, 2015. (Photo: Rich Pedroncelli, AP) 
  
 Measles is one of the most contagious viruses and spreads easily when infected people breathe, cough or sneeze. People who aren't protected — because they haven't had measles or a vaccine — can contract the virus even two hours after an infectious person leaves the room. 
  
 The last confirmed measles death in the United States was reported in 2003, according to the Centers for Disease Control and Prevention. 
  
 "These are communicable diseases," Schaffner said. "They don't just happen to me. They can be spread to others, often unknowingly so." 
  
 Contributing: Meghan Hoyer. 
  
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A:
A woman in Washington state who fell ill earlier this year and died is now said to have died from pneumonia caused by measles—making it what health officials say is the first measles death in the country since 2003, the Seattle Times reports. The cause of death of the woman, who was in her 20s, was determined only after her autopsy, reports USA Today. Her illness is likely linked to an outbreak that took place in Clallam County in the spring: She was reportedly treated at a medical center at the same time as another patient who later developed a rash and was determined to be contagious for measles; the paper notes the disease can be spread even before outward symptoms manifest. The woman's death makes it the sixth confirmed measles case in Clallam County, and the 11th in Washington this year, per the Times. Many of the cases nationwide—178 so far this year, notes the CDC—were part of a larger outbreak believed to have started in Disneyland. State health officials say the woman had "several other health conditions" and was taking meds that helped suppress her immune system. A California state senator and pediatrician who advocated for his state's tougher vaccine laws tells USA Today that he was "so sorry to hear about this preventable tragedy" and that it underscores "exactly why the law" is necessary. (Jim Carrey does not agree with him.)