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SAO PAULO (AP) — Brazil’s Health Ministry says more than 1,000 people have been infected and five have died in a measles outbreak linked to cases imported from neighboring Venezuela.

The ministry says on its website that 1,053 cases of the disease have been reported so far this year.

All but 31 of these cases have been registered in the northern jungle states of Amazonas and Roraima that share borders with Venezuela, where health services have collapsed amid political and economic turmoil. Four died in Roraima and one in Amazonas.

Hardships in Venezuela have sent more than 1 million people fleeing to neighboring countries, sometimes bringing diseases with them.

Measles spreads through the air and is highly contagious, though a vaccine against it is very effective. Brazil is ramping up vaccination efforts.