A North Carolina school with a large anti-vaccine community is at the heart of the state's largest chickenpox outbreak in decades, officials say.
On Friday 36 students at Asheville Waldorf School were diagnosed with the disease, the Asheville Citizen-Times newspaper reported.
The school has one of the state's highest rates of religious exemption, allowing students to skip vaccination.
"This is the biggest chickenpox outbreak state health officials are aware of since the vaccine became available," a North Carolina Department of Health spokesman told the BBC in an emailed statement.
Out of the Waldorf School's 152 students, 110 have not received the vaccine for the varicella virus, known to most as chickenpox, the Citizen-Times found.
And 67.9% of the school's kindergarten students had religious immunisation exemptions on file in the 2017-2018 school year, according to state data.
The primary school is fully co-operating with local health officials and is compliant with all North Carolina laws, a spokesperson for the school told the BBC.
"We find that our parents are highly motivated to choose exactly what they want for their children. We, as a school, do not discriminate based on a child's medical history or medical condition."
Buncombe County, home to the city of Asheville, with a population of over 250,000, has the highest rate of religious-based immunisation exemptions in the state.
"We want to be clear: vaccination is the best protection from chickenpox," County Medical Director Dr Jennifer Mullendore said in a statement.
North Carolina law requires certain immunisations, including chickenpox, measles and mumps for kindergarteners, but the state allows for medical and religious exemptions.
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Should the exemption be allowed!?
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