Israel’s Health Ministry warned the public on Tuesday to vaccinate children in the wake of a significant increase in the number of cases of measles in 2018.

Since the beginning of the year, 262 cases of measles have been reported, compared to 33 cases in 2017 and only nine in 2016.

According to the ministry, 90 percent of the cases occurred in people who had not been vaccinated or had been in contact with unvaccinated people.

Though measles was once a common illness, vaccinations kept it at bay. It is fatal in 1 out of every 1,000 cases.

According to the World Health Organization, measles kills approximately 134,000 children a year.