COLUMBUS, Ohio (WCMH) — There are now 56 confirmed cases of measles in Columbus and central Ohio — including in two partially vaccinated children.

As of Monday afternoon, Columbus Public Health confirmed there are 56 cases in its measles outbreak dashboard, up from 50 reported Friday. The continued spread comes after last week’s announcements that measles exposures were confirmed at four public locations and a confirmed case in Westerville City Schools.

More than half of cases are in children under 2, according to the dashboard. Twenty children have been hospitalized, and none have died.

Two confirmed cases are in partially vaccinated children, who have received one dose of the two-dose measles, mumps and rubella vaccine. One dose of the MMR vaccine is 93% effective against infection, according to the Centers for Disease Control and Prevention. The full vaccination is 97% effective against the virus.

CPH shared the following public locations with confirmed measles exposures:

Measles is a highly contagious virus transmitted through coughing and sneezing. According to the CDC, infected individuals can spread the virus for up to four days before becoming symptomatic. It typically takes 8 to 12 days after exposure for symptoms to develop, according to Columbus and Franklin County public health agencies.

The CDC recommends all children receive two doses of the MMR vaccine, with the first between 12 and 15 months old and the second at 4 through 6 years of age or at least 28 days after the first dose.