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COLUMBIA, S.C. (WIS) - Four additional cases of measles have been reported in South Carolina. The South Carolina Department of Public Health said Tuesday that four new cases have been reported, bringing the total number reported in South Carolina this year to 23. Of that number, 20 are associated with an outbreak at two Spartanburg County schools and a Greenville County gym. DPH said that of the four new cases, two were from those who were already quarantining after being exposed to close contacts, and the other two were related to a business in Spartanburg. None of the cases resulted in additional public exposure, according to the agency. DPH also said a child was exposed to measles on Sept. 30 at a Crunch Fitness location on South Pleasantburg Drive in Greenville. Anyone who was at that location on that day between 11 a.m. and 3 p.m. is asked to see their healthcare provider if they believe they were exposed. The case above is now being counted as part of the current outbreak due to “unrecognized community transmission,” the department said in a statement. DPH also reported Tuesday that the exclusionary period for Global Academy in Spartanburg County is over, and the quarantine period for students at Fairforest Elementary ends Wednesday. A mobile unit from DPH will also offer measles vaccinations later this week in Spartanburg County. Symptoms of measles include fever, cough and a runny nose - followed by a rash that can last up to six days. More severe complications such as pneumonia, brain swelling and death can also occur. Health officials recommend the MMR and MMRV vaccines as the best way to protect against measles. Feel more informed, prepared, and connected with WIS. For more free content like this, subscribe to our email newsletter, and download our apps. Have feedback that can help us improve? Click here.