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With nine cases of measles now confirmed in Pima County, health officials are warning that the disease is likely spreading through the community.

Their worst fears are becoming real as a single measles case — discovered six weeks ago at Northwest Medical Center — continues to trigger infections among Tucsonans.

As a result, health officials are now urging earlier measles vaccinations for infants, who are extremely vulnerable to serious complications from the virus.

"We can track all the new cases back to the original case. But now the infections are occurring outside of the hospital, and that has us very concerned," said Patti Woodcock, spokeswoman for the Pima County Health Department.

Though it's now rare in the United States due to high childhood vaccination rates, the measles virus spreads easily through the air and is considered one of the most contagious of all infectious diseases.

In the worst cases, measles can progress to pneumonia or encephalitis and can cause seizures, deafness and even death.

The original Tucson case — "patient zero" — was a female tourist from Switzerland who became ill in mid-February and went to Northwest Medical Center for treatment. But she was not confirmed as having measles until three days later, when she was finally isolated.

Because Northwest's emergency room was packed with flu sufferers during that period, health officials feared many may have been exposed to the highly contagious virus. A second case was confirmed in early March, in a patient who was in the Northwest ER at the same time.

With seven more cases since then, it's clear the virus has moved outside of Northwest.

"Bless her heart — this lady from Switzerland did a good job of spreading it throughout the community," Woodcock said.

Eight victims, including the Swiss tourist, have recovered, while one remains hospitalized.

Even a single measles case is rare in Pima County, where only one "probable" case has been recorded in recent years — in 2007, the only case that year in the entire state.

Measles cases dropped dramatically nationwide after 1957, the year that the MMR vaccine — for measles, mumps and rubella — was developed. The disease was considered virtually eliminated in the United States by 2000.

However, controversy in recent years about a suspected link to autism has affected vaccination rates somewhat here, and to a large degree in Britain and elsewhere in Europe, where major outbreaks are now occurring.

European tourists visiting the United States in recent years have set off small outbreaks here — in Indiana in 2005, more recently in San Diego and now in Tucson.

A statement issued Monday by the county Health Department said: "Complications from measles are of utmost concern to public-heath practitioners. One to two children in a thousand can die from measles infection. The best way to prevent it is to get vaccinated."

Due to the current threat, officials are recommending that all infants be vaccinated early — at 6 months rather than at 1 year. Two subsequent doses will be needed to ensure lasting immunity.

Americans born before 1957 were exposed to epidemic measles outbreaks for years, and about 95 percent to 98 percent are immune.

Early measles symptoms — fever, cough, runny nose — can be confused with the flu. But later symptoms — red eyes and the telltale body rash — are clear signals of the disease.

Anyone who suspects a measles infection is urged to contact a health-care facility or a doctor's office before arrival, so treatment can be arranged without exposing others.