Measles is a highly contagious acute respiratory virus that was previously considered to be eliminated in the United States. Since late January of 2025, there have been a total of at least 712 measles cases, according to the CDC. Additionally, the CDC reports that “there have been 7 outbreaks (defined as 3 or more related cases) reported in 2025, and 93% of confirmed cases (660 of 712) are outbreak-associated.”

While the majority of infections have been centered in the Panhandle and South Plains regions of Texas (541 of the 712 total cases), 21 other jurisdictions have also reported at least one case, five of which are also experiencing an outbreak. This list includes Alaska, California, Colorado, Florida, Georgia, Kansas, Kentucky, Maryland, Michigan, Minnesota, New Jersey, New Mexico, New York City, New York State, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Vermont, and Washington.

So far, 11% of patients have been hospitalized, with children under five years old being the most likely to need hospitalization. According to the Associated Press, there have been three deaths from measles so far this year. This is in comparison to the total of three deaths that have occurred in the past 25 years, from 2000 to 2025.

Signs & Symptoms

The first steps in stopping the spread of measles are recognizing the signs and symptoms of the disease and knowing what to do if you have been exposed or think you might be infected. 

Symptoms usually begin 7-14 days after exposure and may seem flu-like at first; early symptoms include fever, cough, runny nose, red eyes, and sore throat. Three to five days later, the patient will usually develop the red, spotted rash indicative of measles. The rash generally starts at the hairline or face and moves down the body. The person could also develop a very high fever and blue-white spots inside the mouth (Koplic spots). 

Measles is particularly dangerous because of how contagious the virus is. One person with measles will infect an average of 18 people, each of which will infect 18 more and so on; this is compared to COVID-19 (before the vaccine) where one sick person will infect three others. Additionally, an infected person is considered to be contagious from four days before the rash appears to four days after, meaning someone could unknowingly and unintentionally spread the disease to others. The virus spreads when a person with measles sneezes, coughs, or talks – releasing the virus into the air - and when a non-infected person comes into contact with contaminated surfaces. Part of the reason the measles virus is so contagious is that it can live in the air or on a surface up to two hours after the infected person has left the room. 

Serious side effects of measles can include pneumonia, encephalitis (inflammation of the brain), and death. Babies and young children are at a greater risk for complications and death than adults. A patient should  seek emergency care and go to an emergency room if they are having a hard time breathing, are breathing faster than normal, are showing signs of severe dehydration, or are experiencing confusion, decreased alertness or severe weakness. Children should be taken to the ER if they have a blue color around the mouth, are crying without tears, have unusually low energy, or have a severe loss of appetite.

Vaccination is Key

There is no cure for the disease, so the best way to avoid serious complications is to get the measles vaccine. The measles vaccine is included in the MMR (measles, mumps, and rubella) and MMRV (measles, mumps, rubella, and varicella) vaccines. The CDC recommends two doses of the MMR or MMRV vaccine, one between 12 - 15 months of age and one between 4 - 6 years old, before the child enters school. Two doses of the measles vaccine are 97% effective at preventing measles and one dose is 93% effective. On the flip side, nine out of ten unvaccinated people exposed to the measles virus will become infected, so it is crucial to make sure patients are up to date. Those born before 1957 are considered to have presumptive immunity as they likely had the virus as a kid. However, if a patient was vaccinated between the years 1963-1967, it is recommended that they get at least one more dose, as the vaccine used during that time period was not as effective as the current one. 

The level of herd immunity which allows for measles to be eliminated is established when at least 95% of the community is vaccinated, so it is imperative that everyone do their part. The MMR vaccine can be given within 72 hours of exposure under certain circumstances, but that should be used as a last resort and prior vaccination should be prioritized.

Talking to Patients about Measles

Those who have to move, like farmworkers, should take the appropriate precautions before and after travelling. Clinicians should encourage anyone above the age of 12 months to receive both doses of the vaccine at least two weeks before travel. Even if travel is less than two weeks away, everyone should get at least one dose. Upon arriving at your destination, patients should be instructed to watch for symptoms of measles for three weeks and isolate if any appear or if they discover they were exposed.

It is important to inform patients that all people have the right to emergency care, no matter their insurance or legal status. Patients should call ahead to inform the hospital, clinic, or office of a possible measles infection so they can take the proper steps to prepare.

Health misinformation continues to circulate and is growing among foreign-born communities including in farmworker communities. It is critical to maintain strong relationships with our communities so that health messages come from trusted sources – not the internet. Relying on informed and trained Community Health Workers and providing multilingual and low-literacy resources to back up these health messages can save lives.

In order to provide more information on how to prevent measles and what to do at the individual, family, school, or community level when someone is diagnosed with the disease, MCN will be hosting a webinar this Thursday, April 17 at 1:00 pm PT/3:00 pm CT/4:00 pm ET and AT in English with simultaneous Spanish interpretation. There will also be a session in Spanish on April 24 at 1:00 pm PT/3:00 pm CT/4:00 pm ET and AT.   Participants can receive a Continuing Medical Education credit or a Continuing Nursing Education credit. It is appropriate for all clinicians, including Community Health Workers. You can sign up for the webinars, titled Measles Alert! An Update for Prevention, here.

Register for the webinar here

Visit MCN’s Vaccination Information Hub for clinician resources, resources for community organizations, and printable multilingual and low-literacy patient-facing resources, including Adults Get Vaccinated Too, our comic in English and Spanish.