Healthcare Providers: Stay Alert for Measles Cases

Stay Alert for Measles Cases

Since early 2025, measles cases have been increasing and we've had several large outbreaks. There were 49 outbreaks in 2025 (defined as three or more cases), and 87% of cases were outbreak-associated. Most cases were among children and adolescents who had not received a measles vaccine or whose vaccination history was unknown. Three measles deaths were reported: one in an unvaccinated adult in New Mexico and two in unvaccinated school-aged children in Texas. Measles cases continue to be reported in jurisdictions across the United States.

Measles is extremely contagious and begins with fever, cough, coryza (runny nose), and conjunctivitis (pink eye), followed 2–4 days later by a rash that starts on the face and spreads downward on the body. Infected people are contagious from 4 days before the rash starts through 4 days afterward. The virus is transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes and can remain infectious in the air and on surfaces for up to 2 hours after an infected person leaves an area. Measles can cause severe health complications, including pneumonia, encephalitis, and death. MMR vaccination remains the best way to protect against measles and its complications.

If you suspect your patient has measles or was exposed to measles:

• Isolate your patient with suspected measles immediately, ideally in a single-patient airborne infection isolation room (AIIR), or in a private room with a closed door until an AIIR is available. Patients who think they may have measles, or their caregiver, should call ahead so healthcare facilities can limit additional exposures, including offering measles triaging and testing outside the facility.
• Immediately notify public health: 24-hour Epi On Call contact list. Health departments will provide guidance on testing, isolating, and managing patients with suspected measles and people exposed to measles. People exposed to measles who do not have evidence of immunity may be eligible for post-exposure prophylaxis either with MMR vaccine (within 72 hours of exposure) or immunoglobulin (within 6 days of exposure). Collaboration with public health authorities can help ensure that appropriate follow-up occurs for exposed patients who are being, or may have been, discharged.
• Collect samples for both molecular (rRT-PCR) and serology (IgM) diagnostic testing. Collect either a nasopharyngeal (NP) swab or throat (OP) swab for reverse transcription polymerase chain reaction (rRT-PCR) testing, as well as a serum specimen for serology (IgM) testing. Collecting a urine specimen along with an NP/OP swab may improve sensitivity of testing.
• Manage patients with supportive care. There is no specific antiviral therapy for measles. Medical care is supportive to help relieve symptoms. Complications, such as pneumonia and other infections, should be appropriately tested and treated. Vitamin A may be administered to patients with confirmed measles under the supervision of a healthcare provider. Overuse of vitamin A can lead to toxicity and cause damage to the liver, bones, central nervous system, and skin. Pregnant women should avoid taking high levels of vitamin A as it has been linked to severe birth defects.

CDC issued a Health Alert Network (HAN) health advisory about the 2025 measles outbreak on March 7, 2025 (available here). For the most up-to-date information on measles cases and outbreaks in the United States, visit: Measles Cases and Outbreaks.