By Nathaniel Ratnasamy, MD, and Gina Bailey, BSN, RN

There has been concern about measles cases in various parts of the United States and a significant uptick worldwide. According to the CDC, 2025 was the most active year for measles since 1992, and this trend is continuing into 2026. There were 2280 confirmed U.S. cases in 2025, and as of February 12, 2026, there have been 910 confirmed cases. There have been 5 new outbreaks reported in 2026, and 90% of confirmed cases (822 of 910) are outbreak-associated (62 from 2026 outbreaks and 760 from 2025 outbreaks). 

Measles is among the most contagious infectious diseases; up to 9 out of 10 susceptible persons with close contact with a measles patient will develop measles. The virus is transmitted by direct contact with infectious droplets when an infected person breathes, coughs, or sneezes. The measles virus can remain infectious in the air for two hours after an infected person leaves an area.

The time between exposure to the measles virus and the onset of symptoms is typically 11–12 days. These symptoms may include fever, cough, stuffy nose, and red eyes. Then, there may be tiny white spots on the inside of the mouth known as Koplik spots. Three to five days after initial symptoms, a rash of both flat and raised skin lesions begins on the head and face and then spreads downward to the neck, trunk, arms, legs, and feet. Fevers may spike to more than 104◦ F.

Measles can cause severe health complications, including pneumonia, encephalitis, and death. One in five people with measles is hospitalized, one in 20 develops pneumonia, and one in 1,000 develops encephalitis. Measles, mumps, and rubella (MMR) vaccination remains the best way to protect against measles and its complications.

Measles was officially eliminated from the United States in 2000, meaning no measles is spreading within the country. This was accomplished by a very high percentage of people receiving the safe and effective MMR vaccine, introduced in 1963. The risk of measles remains low for most of the United States due to high immunization coverage and rapid case identification. The increase in U.S. cases is due to people returning from international trips with measles and an expanding outbreak among communities with low vaccination coverage. Among the 607 cases reported in 2025, 436 were among unvaccinated or under-vaccinated children under 19. The remaining cases were adults who were unvaccinated or had unknown vaccine status.

The Centers for Disease Control (CDC) recommends two doses of measles-containing vaccine: the first at age 12 - 15 months and the second at age 4- 6 years before school entry. Adults should also have received 1 or 2 doses (depending on risk factors), unless they have other presumptive evidence of immunity to measles. A small number of adults who received the inactivated measles vaccine during childhood from 1963 through 1967 are considered unvaccinated and should receive at least one dose of MMR vaccine. For more information about MMR vaccination, talk to your health care provider or your local health department. 

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Nathaniel Ratnasamy, MD, is an Infectious Disease Specialist at Blanchard Valley Health System. Gina Bailey, BSN, RN, is an Infection Preventionist at Blanchard Valley Health System