As of noon on Thursday, July 30, we have more recorded cases of measles in the United States than we did in all of 2025.
The 2,371 confirmed cases, 167 of which are in Pennsylvania, constitute the most cases of measles we’ve seen in the U.S. since 1991. Perhaps the most telling piece of data we have around this series of outbreaks is that 93% of those who are infected are unvaccinated or their vaccination status is unknown, while 7% have received one or two doses of measles-mumps-rubella (MMR) vaccine.
As you can see in that data, the MMR vaccine doesn’t prevent all measles infections. But it’s so effective that for many years, U.S. outbreaks were caused by international travel, which sparked isolated spread in unvaccinated communities.
In fact, in 2000, measles was declared eliminated in the U.S., meaning the absence of continuous spread was greater than 12 months. That status was maintained for more than 20 years because of vaccine adoption.
Measles is the most contagious virus we know of, because the tiny respiratory droplets that are expelled by an infected person can live in the air or on surfaces for more than two hours. The disease causes a total-body skin rash and flu-like symptoms, and there is no specific medical treatment to reduce discomfort.
Early signs of measles include:
• Dry cough
• Stuffy, runny nose
• High fever that can spike as high as 104°F
• Sore throat
• Red, watery eyes (pink eye)
•Small, red spots with bluish-white centers inside the mouth.
Measles is most prevalent among children and can cause dangerous health implications like brain and lung infections — especially in children younger than 5.
The characteristic rash begins three to five days after early symptoms and starts as flat, red spots on the forehead before spreading to the rest of the face, torso, arms, legs, and feet. It can be itchy, uncomfortable, and last up to seven days. The spots often come together in patches of red, blotchy skin.
Infected people are most contagious from about four days before the rash appears until about four days after it appears. Those with weakened immune systems can be contagious longer.
The virus usually takes 10 to 14 days to run its course. You can manage symptoms by staying hydrated, getting plenty of rest, taking over-the-counter pain medications to reduce fever and discomfort, and using a saline nasal spray or a humidifier to help clear congestion.
Children younger than 5, pregnant women, and people with weakened immune systems may also be susceptible to ear infections, croup, and more serious complications like pneumonia and encephalitis, which is swelling of the brain.
The most effective way to prevent measles is to get our children age-appropriate doses of the MMR vaccine. It’s typically administered when children are between 12 and 15 months old and again between 4 and 6 years old.
With outbreaks happening across the country, it’s also important that we limit our exposure to others who are infected, practice good hand hygiene, and stay informed on where and how widely the disease is spreading.
Before the measles vaccine was developed, measles infected between 3 and 4 million Americans each year, killed between 400 and 500, hospitalized 48,000, and left 1,000 suffering with encephalitis.
Let’s do our best to prevent that from happening ever again.
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Dr. Alfred Casale, a cardiothoracic surgeon, is chief medical officer for surgical services for Geisinger and chair of the Geisinger Heart and Vascular Institute. Readers may write to him via ae@timesleader.com.
