HANOVER — The number of cases in a multistate outbreak of measles linked to an international traveler to Hanover in June has grown to five, according to the New Hampshire Department of Health and Human Services.

The fifth case in the outbreak is a resident of another state who had been exposed to the traveler with measles who visited Hanover. That individual also visited New Hampshire while they were infectious with measles.

The Vermont and New Hampshire departments of health had previously each announced cases of measles in residents who had been exposed to the international traveler. The tally also includes the original traveler and another Granite Stater — a case state officials had not previously announced because the person isolated at home when they started feeling sick and did not expose others to measles, a DHHS spokesperson said in a Friday email.

Also on Thursday, the Massachusetts Department of Public Health announced the first case of measles in a Massachusetts resident since 2020. The person from Worcester County had recently traveled internationally. 

As of July 11, a total of 167 measles cases had been reported across the United States so far this year, according to the U.S. Centers for Disease Control and Prevention. Many of the cases reported in the United States are tied to recent travel, according to the Massachusetts Department of Public Health. Large measles outbreaks are ongoing in Europe and elsewhere internationally.

The international traveler to Hanover visited from June 20 to 22 and made stops at Dartmouth College, the Hanover Inn, Hanover Scoops and Lou’s Restaurant and Bakery, the New Hampshire Department of Health and Human Services previously said. The individual also took the Dartmouth Coach to and from Hanover from Boston’s Logan Airport and flew to Amsterdam.

In addition, the infected Granite Stater visited several Upper Valley locations in early July while they were infectious, including:

■July 1, 1:30 to 3:30 p.m.: Peppermint Patty’s, 25 Road Round the Lake, Grantham

■July 1, 5:30 to 11:30 p.m.: Sierra Trading Post, 200 S Main Street, West Lebanon

■July 3, 9 to 11:30 a.m.: Dartmouth Co-op, 21 S Main Street, Hanover

■July 5, 9 a.m. to 12:30 p.m.: Dartmouth Co-op, 21 S Main Street, Hanover

■July 5, 11:45 a.m. to 6 p.m.: ClearChoiceMD Urgent Care waiting room, 410 Miracle Mile, Lebanon

■July 6, 8 to 10:30 a.m.: ClearChoiceMD Urgent Care waiting room, 410 Miracle Mile, Lebanon

■July 6, 9:30 a.m. to July 7, 1 a.m.: Dartmouth Hitchcock Medical Center Emergency Department, 1 Medical Center Drive, Lebanon

A full list of New Hampshire locations, dates and times where people may have been exposed to measles is online at: dhhs.nh.gov/programs-services/disease-prevention/infectious-disease-control/measles.

Locations are removed from the list after 21 days, the maximum amount of time it takes for people with measles to develop rash symptoms following an exposure.

In addition to the body rash, symptoms include high fever, cough, runny nose and watery eyes.

People who are not protected from measles include those who are not immune, either through prior infection or vaccination, as well as those with weakened immune systems, and infants who have not yet been vaccinated.

Those who are not protected or are unsure of their protection against measles and may have been exposed should contact the New Hampshire Division of Public Health Services at 603-271-4496 and monitor for symptoms.

Dartmouth Health has established a measles hotline for people with symptoms who may have been exposed: 603-650-1818.

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.