Measles is rebounding in the US: What you need to know -

On Wednesday, November 26, 2025, the United States had its first death from measles since 2015. The fatality was an as yet unidentified school-age child who had not been vaccinated. The child died while hospitalized in Covenant Children’s Hospital in Lubbock, Texas.

Despite being somewhat trivialized as just a “childhood disease” by a growing number of people, Rubeola virus remains a formidable foe. Like any other virus, when given the opportunity, Measles will continue to take more and more lives and leave other victims with life-long problems. That’s what viruses do.

Texas health officials state that 20 people have been hospitalized from the childhood disease. At least 146 people have been infected, mostly small children and teenagers. All but 5 of the cases are in unvaccinated people. The cases were originally concentrated in a “close-knit, under-vaccinated” rural Mennonite community in Gaines County, according to Texas healthcare officials.

At this time, it is unclear how the first person was exposed, and there is no indication that any early patients traveled outside the United States, according to a Texas health department spokesperson.

The measles outbreak has grown from a handful of cases to more than 130 across two states, having crossed the border into eastern New Mexico. On Tuesday, New Mexico announced nine cases.

How contagious is Measles (Rubeola) virus?

Measles (Rubeola) is one of the most highly contagious viruses known to science. It is far more contagious than Influenza or Covid. Additionally, the virus can live in the air and on surfaces for 2 hours after the infected person has left the area.

Symptoms of the disease do not appear until 10 to 14 days after exposure to the virus, and according to the Center for Disease Control (CDC), a person with measles can infect others for four days before the rash becomes evident and for four days after the rash appears. Therefore, the highly contagious virus can be easily spread by someone who does not yet know that they are sick. A person with measles will typically infect 9 of every 10 susceptible people with whom they come into close contact. In a completely susceptible population, one measles patient will probably infect 12-15 others.

Health officials note that the Texas outbreak was spread when one contagious Gaines County resident traveled to several locations in and around San Antonio, nearly 400 miles away.

Persons with measles should be isolated from others for four full days after their rash appears. On day five, they can generally resume whatever activities they feel like doing.

What are symptoms and possible complications of measles?

Measles is an unpleasant experience, but usually passes in about 7 to 10 days without causing any further problems. However, measles can lead to serious and potentially life-threatening complications in some people. Children under 5, adults over 30, pregnant women and people with weak immune systems are at higher risk for complications.

Initial symptoms include cough, runny nose, red, watery eyes, and fever (104 degrees or more). A red, blotchy rash appears on the face and spreads to the body, as well as white spots on lips and inside cheeks. Sensitivity to light and muscle pains may also occur.

Diarrhea, middle ear infection and pneumonia are common complications of measles.

The risk for serious complications or death is highest for children aged 5 or below and adults age 20 or older. Less common, but severe complications can include bronchitis, croup, seizure, blindness (rare) and encephalitis, which can cause permanent brain damage. Death occurs in from 1 to 3 of every 1000 cases.

At 5-10 years after recovery from measles, about 1 in 5000 reported cases develops subacute sclerosing panencephalitis (SSPE). This progressive neurologic disorder causes mental and motor deterioration, which can progress to coma and death. Its rates are higher among children who had measles before age 5 years.

How did we get here?

Measles virus diverged from rinderpest virus in the 6^th century BCE, possibly coinciding with the rise of large cities. Rinderpest virus was a highly contagious and fatal viral disease that primarily affected cattle and other cloven-hoofed animals. Rinderpest was eradicated globally in 2011.
Measles spread throughout the world from the Renaissance period to the 20th century.
Europeans brought measles to America during the European colonization of the Americas. Measles was just one of many deadly viruses and bacteria that Europeans brought to the Americas.
The World Health Organization states that before widespread vaccination, measles caused an estimated 2.6 million deaths each year worldwide.
The first measles vaccine (a live virus type) was licensed in the U.S. in 1963. The MMR (Measles, Mumps, Rubella) vaccine was developed in the 1970s.
In 2000, measles was declared eliminated from the U.S. due to a highly effective vaccination program.
In 2016, about 90,000 people died worldwide of measles, the first year on record when global measles deaths fell below 100,000 a year.
From 2017 to 2019, rates of measles and deaths increased due to a decrease in immunization.
In 2023 the United States reported there were 59 cases of measles in 4 outbreaks; in 2024 there were 285 cases in 16 outbreaks.
In 2023, 107,500 lives, mostly children, were lost to measles worldwide.

General vaccine hesitancy has been steadily growing in the United States since 2017. According to the National Institutes of Health (NIH): “Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of individuals. Lack of confidence in vaccines is now considered a threat to the success of vaccination programs. Vaccine hesitancy is believed to be responsible for decreasing vaccine coverage and an increasing risk of vaccine-preventable disease outbreaks and epidemics.”

Robert F. Kennedy, Jr., a long-time critic of vaccines, was nominated by President Trump for the office of Secretary of the US Department of Health and Human Services. Kennedy has a long history of sharing inaccurate information about vaccines, including the measles vaccine. Along with other items, Senators questioned Kennedy about his position on vaccines during the confirmation process. Louisiana senator Bill Cassidy, himself a physician, grilled Kennedy about his position on vaccines before voting to approve the appointment. Cassidy has made statements calling the Texas child’s death “absolutely devastating news.” He stated that the measles vaccine is “safe and effective” and encouraged parents to make sure that their children are up-to-date on their vaccines.

At a February 26th cabinet meeting, a reporter asked President Donald Trump whether he was concerned, given news earlier in the day about a a child’s death from measles. Trump asked Kennedy, who was in the room, to respond. Kennedy downplayed the seriousness of the ongoing measles outbreak in Texas, falsely claiming that people had been hospitalized “mainly for quarantine” and misleadingly stating that the situation is “not unusual.”

Responding to Kennedy’s statements, Dr. Lara Johnson, the chief medical officer of Covenant Health Lubbock Service Area said, “We don’t hospitalize patients for quarantine purposes. Quarantine is not something that would happen in a healthcare facility. We admit patients who need acute supportive treatment in our hospital.”

Measles vaccine: Who needs it?

The disease remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine. The measles vaccine is said to be about 97% effective. For a community to be protected against an outbreak, 95% of its people must be vaccinated.

The American Academy of Pediatrics recommends children get vaccinated with their first MMR dose between the ages of 12 to 15 months. A second dose is recommended at age 5-6 years, before entering school.
People who had measles as a child, likely have lifelong immunity to the disease.
People born before 1957 are likely immune to measles because they lived through an epidemic before the vaccine was available.
Adults who were born after 1957 and were vaccinated before 1968 should consider getting one dose of MMR, because early vaccines were not as effective as later vaccines.
Adults at high risk, such as college students, healthcare workers, and international travelers, should receive two doses of the MMR vaccine.
If you’re not sure of your immunity or vaccination status, there’s no harm in getting a shot.
Pregnant women exposed to measles should talk to their doctor as soon as possible — within six days — to know if they should receive a post-exposure prophylaxis with measles immunoglobulin, per CDC recommendations.
Measles in pregnancy is associated with a higher risk of miscarriage, low birth weight and preterm birth, but pregnant women should not receive the MMR vaccine, because it is a live virus.

Some people should not get the MMR vaccine: check with your health care provider if certain conditions apply to you.

What if I’m exposed to, or get, the measles?

If you get the MMR vaccine within 72 hours of being exposed to measles, the CDC said you can also get some protection against the disease, or have milder illness.
There is also a medication, immunoglobulin, that if provided within six days of being exposed to measles, can offer some protection against the disease and severity of illness.

There have been reports of concerned parents lining up to have their children vaccinated in light of the current Texas/New Mexico outbreaks of measles. That’s good to hear, but they might have saved themselves a great deal of stress and possible exposure to illness had they been more proactive.

Any lessons learned? We can only hope so.

CDC Recommendations for Measles vaccine (Routine and Special Circumstances).

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Nan Shiverdecker for NEMISS.NEWS