Once. You don't know how many times they are going to continue sneezing so once is enough, I would think they get the picture that you are wishing them good health.
1st: Bless you!
2nd: You alright? (or) Get it all out of your system?
If yes: Ok, bless you.
If no: Ok. (Then wait until they're done, and say bless you again. And "Goodness!" depending on how many times they sneeze.)
First time is fine in etiquette. Some people think it's cute to say it the second and third time, but it can bother some people simply because it's so repetitive. I usually don't say anything unless it's a close friend of mine. Then, I say, "Oh another orgasm again!"