And it comes just after a measles scare on a Hawaiian Airlines flight from San Diego where an infected toddler was onboard.

"The adult female unfortunately didn't get picked up until she happened to watch the news story covering the 10-month-old and saw pictures of what should measles rash look like and thought 'gee this might be what it is'," said Dr. Sarah Park of the State Department of Health.

The woman wasn't on that flight. Instead she contracted the disease somewhere in Europe before Feb. 5. That's when she returned to Oahu.

The State Department of Health said she was highly contagious between Feb. 6 and the 14 and health officials with the state are now tracing her steps to find out who may have been exposed to the disease.

"She was seen in an ER and unfortunately at the time her physician didn't recognize that he needed to report it," Dr. Park said. "So this could have gone under the radar for a little while until the lab popped up on our screen, and that would be after the fact."

Residents who are most at risk are babies under one year old who have not been vaccinated for measles or elderly residents with weakened immune systems.

"It can be fatal," Dr. Park said. "I believe the statistics in the U.S. are 1 to 3 out of a 1,000 will die from measles."

Dr. Park said death rates would be much higher if it wasn't for the fact so many Americans are immunized. She said this case is a reminder of how important it is to get vaccinated.

The state will be continuing to contact those who may have been in contact with the infected woman.

Symptoms associated with an onset of measles include a fever, cough, runny nose, red or watery eyes, and a rash.

Those who believe they are infected are advised to stay home and call a doctor.

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