Measles is back. What to know about how to keep yourself safe

Measles is one of the most contagious viruses on Earth. If you haven’t been vaccinated with two shots of the measles, mumps and rubella (MMR) vaccine or actually had the disease in your past, you can get it very easily. If you simply enter a room where someone with measles has coughed or sneezed within the past two hours — even if that person is no longer in the room — you can contract it.

It’s very dangerous. On Feb. 26, an outbreak that began in Texas led to the first death due to measles. Notably, the last death in the United States due to measles was in 2015; it was believed to be associated with the large outbreak at Disneyland.

As of March 6, there have been 222 measles cases reported in 12 jurisdictions: Alaska, California, Florida, Georgia, Kentucky, New Jersey, New Mexico, New York City, Pennsylvania, Rhode Island, Texas and Washington. 

There are three outbreaks (defined as three or more related cases) in 2025, and most cases are outbreak-associated. Most cases (94%) occurred in those who were unvaccinated or have an unknown vaccine status; 4% had only one MMR dose and 2% had two MMR doses. 
Among these 222 cases, 76 (34%) were in those under 5; 99 (45%) were in 5-19 years; 40 (18%) occurred in 20+years and 7 (3%) at an unknown age. Seventeen percent required hospitalization. 

The death occurred in a school-aged child who lived in the outbreak area of South Plains, Texas, near New Mexico. A second death in New Mexico, in an unvaccinated adult who tested positive for measles, is still under investigation.

The CDC reports that, for the 2023-24 school year, only 89.2% of Ohio kindergarteners are vaccinated with two doses of MMR. In Texas, where the current outbreak is ongoing, the coverage estimate is at 85% as of 2023, with some areas as low as 80%.

Measles was officially eliminated from the United States in 2000, meaning measles was not spreading. New cases were only found when someone contracted measles abroad and returned with it. Eliminating measles in the United States was a historic public health achievement.

What is measles?

Measles is an acute viral illness transmitted by coughing or sneezing. The incubation period (the time from exposure to the first signs or symptoms) varies from seven to 21 days.

What are the symptoms?

The first sign is a very high fever (up to 105 degrees), followed by a flat, then raised, red rash. The tiny red spots of the rash start on the head/face and travel down to the neck, chest, arms and legs. The rash usually appears about 14 days after the initial exposure.

Measles is characterized by its three Cs:

• cough
• coryza (inflammation of the mucous membrane in the nose)
• conjunctivitis (redness in the white part of the eyes)

The rash is the tell-tale sign that you’ve gotten measles. The bad news is that, if you haven’t been vaccinated or had the disease before, you can even get measles from someone up to four days before their rash shows up and up to four days after it appears.

How dangerous is measles?

You can end up in the hospital or even die from a measles-related complication, such as pneumonia. Other complications are diarrhea (especially in young children) and ear infections. Also possible, but less common, is development of encephalitis (a swelling of the brain with altered mental capacity) that could lead to permanent brain damage and deafness. If you’re pregnant and get measles, you could go into premature labor, have a miscarriage or deliver a low-birth-weight baby.

Can measles be treated?

There’s no treatment for measles other than supportive care for symptoms. There may be treatment for complications (pneumonia, ear infections, etc.). If you suspect that you or someone you’re caring for has measles and you’re seeking medical care, it’s critical that you call ahead and alert the hospital or clinic so that precautions can be taken there before you arrive. Patients with measles symptoms should have a mask put on them upon arrival and be placed in airborne isolation, which will help prevent them from infecting others. Caregivers should wear an N95 mask.

Why are we seeing so many measles cases now?

An anti-vaccination movement has been on the rise for several years, with parents refusing to vaccinate their children for religious, philosophical or other reasons. This is sometimes termed “vaccine hesitancy.” Very few of those who refuse the vaccine are old enough to have seen how devastating this infection actually is — in recent history, it’s been “out of sight, out of mind.”

Is there a link between vaccinations and autism?

No. The CDC says there’s no convincing evidence that any vaccine causes autism or autism spectrum disorder. Development of encephalitis after measles, however, can lead to cognitive deficits.

How effective is measles vaccination?

Vaccination against measles is very effective. If you get two doses of the MMR vaccine, the risk of getting measles is less than 3%. Children usually get their first shot at 12 to 15 months; the second shot is at 4 to 6 years, before they start school. If your baby is traveling to an area with a measles outbreak, it’s possible to get the first shot as young as 6 months old — check with your pediatrician.

Do adults need a new measles vaccination?

It depends. The CDC says if you were born before 1957, you probably had measles already and are now immune. If you were born between 1957 and 1989, you may have only received one MMR vaccine, meaning you should get a booster shot for maximum protection. If you got the MMR vaccine between 1963 and 1967, you got what was later determined to be an ineffective vaccine for measles. If so, you should either have your blood checked to see if measles antibodies are present or get the MMR vaccine. There’s no harm in getting another dose if you may already be immune. When in doubt, vaccinate.

Who should not be vaccinated?

The MMR vaccine is a live virus and is not advised for children under the age of 1 (except under special circumstances, like when traveling to an area with a measles outbreak). Also, if you’re pregnant or have a weakened immune system due to cancer, HIV/AIDS or another condition, or if you’re undergoing medical treatment, such as radiation, immunotherapy, steroids or chemotherapy, you should not receive the measles vaccine. If you’re unsure, check with your doctor.

How can I reduce the risk of getting measles if vaccination is not an option?

• Stay home if there’s a measles outbreak at your school or workplace and you or your children have not had two MMR shots or if you’re pregnant or have a compromised immune system.
• Stay away from anyone with a high fever, runny nose and red eyes.
• Always cover your mouth and nose with a tissue when you cough or sneeze, and put used tissues in a trash can.
• Wash your hands frequently with soap and water or use alcohol hand rub.
• Always avoid touching your face, eyes, nose and mouth with your hands.