Measles: What you need to know
The measles outbreak in Texas has sickened at least 300 people who were not vaccinated or whose vaccination status was unknown. Most are children. More than 30 children have been hospitalized, several in the ICU. One has died.
Several other states have reported cases of measles, including New York, New Jersey, Pennsylvania and Maryland. Most of these nearby cases have been sporadic cases from travelers outside the United States.
Typical symptoms of measles are high fever, cough, runny nose and red, watery eyes. That is followed by a red “bucket of rash” poured over the child’s head that begins on the face and hairline, then spreads downward. If there are no complications, the symptoms will usually resolve in about a week.
Why is this outbreak such a big deal? Measles is a very serious viral infection. Prior to the availability of the measles vaccine in 1963, the World Health Organization reported that major measles epidemics occurred every two to three years, resulting in 2.6 million deaths globally in each epidemic year. In the United States, measles caused 3-4 million cases, 48,000 hospitalizations and 400-500 deaths annually.
The vaccine eliminated measles by the year 2000. Elimination means that the virus is not spreading within a community. That elimination status is now on the brink. In 2024, there were 285 cases and 16 outbreaks (three or more cases in a community). Just three months into 2025, we have already exceeded these numbers, and the situation is only getting worse.
One out of five children with measles will be hospitalized. One out of 10 will develop ear infections and potentially suffer permanent deafness. One out of 20 will develop pneumonia, the most common reason that a child with measles will end up hospitalized. One out of 100 end up with encephalitis (brain inflammation). One to three out of every 1,000 patients will die. Measles can also cause “immune amnesia” by killing immune memory cells. That puts the child at increased risk for other infections, including some they previously had immunity against. This increased susceptibility to other illnesses and even death can last for two to three years.
Measles is extremely contagious, much more contagious than COVID or the flu. Nine out of 10 people who are exposed to measles and are not immunized will be infected. Each measles patient infects an average of 12-18 people. Measles virus lingers in small droplets in the air and on surfaces for two hours. Just being in a room where a person with measles has been two hours before is enough to lead to infection. Patients are contagious for four days before before any symptoms appear and four days after the characteristic rash.
Care for a patient with measles consists of isolation or quarantine, fluids and control of fever/discomfort. Only the vaccine prevents measles. One dose of the vaccine is 95% effective. Two doses are at least 97% effective. People exposed to measles should receive MMR (measles, mumps, rubella) vaccine within 72 hours of the exposure. Immune globulin can be given within six days of exposure.
When vaccines eliminated measles and other childhood illnesses, fortunately and unfortunately, the success of those vaccines also helped us start to forget these childhood infections and how serious they can be. Vaccines are becoming victims of their own success.
Since Edward Jenner developed the smallpox vaccine more than 200 years ago, vaccines have been the first line of defense against deadly infectious diseases. They have saved more lives than any other medical intervention in human history. Vaccines will not always keep your child from getting a disease, but they will almost always keep your child from ending up in the hospital or worse. Risks from vaccines are almost always minor, and they far outweigh the risks of the diseases for which they are given. It has been definitively proven in hundreds of studies done all around the world that vaccines, including MMR, do not cause autism.
A child has died from measles. In Texas. In the United States. In 2025. The child was unvaccinated but otherwise healthy. This is the first measles death in the United States in a decade. One child dying from a preventable disease is one too many, and this is probably not the last.
For truthful, reliable and scientifically based information regarding measles, vaccines, illnesses, safety and many other issues concerning children, I highly recommend the parenting website of the American Academy of Pediatrics: healthychildren.org. Please call your child’s pediatrician’s office if you have any questions about vaccines or any other child health-related questions.
