Dutch health authorities said Tuesday they are dealing with a measles outbreak in a devout Protestant fishing village where vaccination rates are among the lowest in the country.

Nine children and one adult have been diagnosed with the disease in the village of Urk, part of the so-called “Bible Belt” in the northern Netherlands, the Flevoland province health service said.

The health service said it was “actively monitoring the situation” and examining whether it was necessary to vaccinate or administer antibodies to people who have been in contact with the infected patients.

“In 2013 and previously, the disease occurred more often on Urk. Many people on Urk have experienced this disease and that means that a natural defence has built up,” it said.

Only 61.1 percent of people are vaccinated against measles in Urk, one of the lowest rates in the Netherlands, where the national average is 92.9 percent, according to the National Public Health and Environment Institute.

Urk is regarded as one of the most devout of the villages in the “Bible Belt” of conservative Protestant communities running from Zeeland in the south of the Netherlands across the country to the north west.

Ninety-four percent of people in Urk regularly go to church, according to the Dutch Central Bureau of Statistics, compared to one in six of all Dutch people.

Dutch newspaper De Telegraaf said that in this devout community of Urk people believe that life and death are in God’s hands, and so vaccinations are not permitted.

Urk is considered a “closed’ community because of its fisheries culture and Protestant orthodox religion,” a European Commission report from 2010 said.

The UN warned in April of a global resurgence of measles—a highly contagious viral infection that can prove fatal—amid a growing “anti-vax” movement worldwide.

The WHO says cases of the once all-but-eradicated disease surged 300 percent in 2018 across the globe.

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