A Clallam County woman has died from pneumonia caused by measles, health officials said Thursday. The last confirmed measles death in the United States was in 2003.

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A Clallam County woman in her 20s died this year from an undetected measles infection discovered only after an autopsy, state health officials said Thursday. The case is the first confirmed measles death in the U.S. in 12 years.

The woman was likely exposed to the highly contagious infection at a local medical center during a recent outbreak in Clallam County. She was at the site at the same time as someone who later developed a rash and was determined to be contagious for measles.

The woman, who had several health conditions and was taking drugs that suppressed her immune system, did not show typical symptoms of a measles infection, Department of Health officials said in a statement. Family members said she had been vaccinated, though they didn’t have documentation. The death was attributed to pneumonia caused by measles, a common side effect of the infection, experts say.

This is the sixth measles case confirmed in Clallam County and the 11th in Washington state this year. Nationwide, at least 178 people in 24 states and the District of Columbia have been diagnosed with measles this year, according to the Centers for Disease Control and Prevention, including many linked to an outbreak that began at Disneyland in Southern California late last year.

The last measles death in the U.S. occurred in 2003, CDC officials said.

The situation highlights the importance of widespread measles vaccination, officials said. Some people, including young infants and people with compromised immune systems, cannot be immunized against the disease or may have reduced immune responses to the vaccine. That leaves them vulnerable to active infections in the community.

Children should receive two doses of the measles, mumps, rubella (MMR) vaccine, with the first dose between age 12 months to 15 months and the second between ages 4 and 6. Adults born after 1956 who have not had the disease should receive at least one vaccination, health officials advise.