The number of reported cases of measles in the Bible Belt region has gone up to 161 and five children have been hospitalised, the public health institute RIVM said on Monday.

The true figure is likely to be higher because not all patients will go to their family doctor, the RIVM said.

The outbreak is largely affecting children aged four to 12 who attend orthodox Protestant schools. Many of the country’s strict Protestant communities do not vaccinate their children on religious grounds.

Exceptional

Two of the hospitalised children have developed pneumonia; two others have meningitis. ‘These are exceptional cases,’ the RIVM told the Telegraaf. ‘The most common symptom is inflammation of the ear.

The symptoms of the fifth child have not been released.

The outbreak began in May with 54 reported cases in the past ten days.