Kentucky has confirmed 104 measles cases this year, the state’s highest total since 1991, as infections continue to rise across the country. More than half of the state’s cases were confirmed in September, according to the state measles dashboard. Christian County has reported 44 cases, the most of any county. By age, 12 cases are in children younger than 5, 47 are in people ages 5 to 17, and 45 are in adults. State data show 102 of the 104 cases were in people who had not been vaccinated against measles. One case was in a fully vaccinated person and one was in someone who had received one dose of the measles, mumps and rubella (MMR) vaccine. No measles deaths have been confirmed in Kentucky. The state’s Department for Public Health has described this as Kentucky’s worst measles year since 1991, when the state recorded 443 cases, mostly among children younger than 5, according to the Centers for Disease Control and Prevention. Measles spreads through the air when an infected person coughs or sneezes. The CDC says one person with measles can infect as many as nine in 10 unprotected people nearby. Symptoms include fever, cough, runny nose, red eyes and a rash. The CDC recommends two doses of the MMR vaccine, with the first generally given at 12 to 15 months and the second at ages 4 to 6. The vaccine is available through medical providers and generally at pharmacies. The outbreak is part of a wider national resurgence. As of Oct. 8, the United States had recorded more than 4,000 confirmed cases and 42 outbreaks, according to the CDC. Measles had been eliminated in the country nearly three decades ago.