Yadkinville, NC -- A chicken pox outbreak in Yadkin County may have caused the death of a child, health officials said. About 50 cases of the sickness have been reported at three elementary schools in the county just west of Winston-Salem, said Debbie Crane, spokeswoman for the state Department of Health and Human Services. A first grader recovering from chicken pox died last week though it was unclear Monday whether the child's death was the result of the illness, Crane said. "Chicken pox deaths are pretty rare," she said. "It could just be a coincidence, but because the child was recovering from chicken pox at the time, we're looking into it." Autopsy results were expected in two to three weeks, Crane said. The highly infectious disease is caused by a virus and results in a blister-like rash, itching, fatigue and fever, according to the Centers for Disease Control. In September, the CDC began recommending children receive two doses of the chicken pox vaccine instead of the previously recommended one dose, Crane said. An immunization requirement for children in North Carolina took effect in 2002. Between 1990 and 1994, before the vaccine was available, about 100 people died from chicken pox nationally each year and about half were children, according to the CDC. Crane said the number of people who catch chicken pox was often difficult to assess because local health officials aren't required to report cases to the state. Yadkin County School officials say they alerted parents to the need for two doses via phone Sunday. To learn more about the sickness and the vaccine visit click here.