Measles Outbreaks in the United States

Children at Risk in Measles Outbreaks in the United States

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Like many families in the United States, you may not be worried about your kids getting the measles. But recent years have brought new outbreaks of this vaccine-preventable disease. The endemic spread of the measles was eliminated in the U.S. in 2000, but cases are again on the rise. Looking at the statistics and how these cases are occurring can be a wake-up call for the need for measles immunization.

Before the routine use of the measles vaccine (1963) and the MMR vaccine (1971), though, measles cases—and complications from those cases—were high. There used to be about 500,000 cases of measles and 500 measles deaths each year in the United States.

Recent Trends in U.S. Measles Outbreaks

Unfortunately, measles cases have been on the rise recently. After hitting a record low number of cases in 2004 (just 37 cases), we seem to continue to hit new record highs for measles every few years now.

There were at least 667 confirmed cases of measles in the U.S. in 2014—the most since 1994. And while 2015 got off to a very strong start, with the Disneyland outbreak in California, it did slow down, ending with 189 cases in 24 states. The next year, 2016, was better with 70 cases in 16 states.

Most concerning, more and more, cases don't seem to have a source that is easy to find, which could mean that the endemic spread of measles has returned in the United States.

So instead of having to travel out of the country or be exposed to someone who got measles with a link to international travel, you could get measles just by going to a ball game, a movie theater, or to Disneyland. That makes it more important than ever to learn how to avoid measles.

Example Cases in U.S. Measles Outbreaks

There were 70 cases of measles in the United States in 2016, including these outbreaks and exposures.

You can see from where and how measles was spread that your children could be at risk in similar situations.

  • A non-publicized confirmed case in Miami-Dade County that was locally acquired with no known link to other cases, no foreign travel, and no known source of infection.
  • A baby in the Denver area who exposed others after traveling out of the country.
  • At least 22 cases in Arizona that are linked to a private detention center, but "may have exposed other people within Pinal and Maricopa Counties." The outbreak has reportedly been hard to contain because many workers refused to get vaccinated.
  • An 8-year-old unvaccinated child in Miami who attended public school exposed up to 100 people. At least 2 other people got measles in this household.
  • At least one unvaccinated person in Fort Wayne, Indiana who exposed others at a local Kohls and Walmart.
  • A case in Illinois after a relative of a Northern Illinois University graduate developed measles while visiting from outside the US.
  • A tourist from Europe who exposed others to measles "from Rockport on the North Shore to Wrentham south of Boston."
  • An unvaccinated 2-year-old who had recently traveled to France, exposing others at an Atlanta area hospital.
  • Seven cases in Shelby County, Tennessee, with six of the children unvaccinated and one, only partially vaccinated.
  • A child at the Yuba River Charter School in Nevada, California, which led the school to shut down for at least a day and may lead to the quarantine of unvaccinated children until early April. Of note, the Yuba River Charter School is a Waldorf School where the vaccine "exemption rate is driven by huge percentages of vaccination opt-outs at public charter schools in the county," and were "81 percent of kindergartners in 2013-14 received personal-belief exemptions." The PBE rate is still at 56 percent for the 2015-16 school year for kindergartners.
  • An unvaccinated child in Richardson, Texas who traveled out of the country and who may have exposed others at his elementary school in the Plano ISD.

Measles Outbreaks - What You Need To Know

Other things to know about measles and measles outbreaks include:

  • From 2 to 5 percent of people do not respond to their first dose of measles vaccine, which is why a second (booster) dose is recommended. But more than 99 percent of people develop immunity to measles after two doses of a measles vaccine, like MMR.
  • A booster dose of MMR was not first recommended in 1989, so many adults born before 1985 may not have had two doses of MMR.
  • Measles is fatal in about 0.2 percent of cases.
  • Very few of the measles cases in these outbreaks are in people who are completely vaccinated. For example, in the outbreaks in Europe in 2011, when 30,000 people got measles, causing 8 deaths, 27 cases of measles encephalitis, and 1,482 cases of pneumonia, most cases were in unvaccinated (82 percent) or incompletely vaccinated (13 percent) people.
  • In addition to many developing countries where measles is still endemic,  international measles outbreaks have been reported in Europe, Japan, and the Philippines, etc., which makes it important to make sure you are fully vaccinated before traveling out of the US.
  • The measles virus is spread by respiratory droplets and can stay in an area for up to two hours after a person with measles symptoms has left.
  • People with measles are contagious from four days before they develop the measles rash.
  • Call your pediatrician if you think your child has measles (don't just show up at their office or in the ER), especially if he develops a high fever and/or rash during a local measles outbreak or after a trip out of the country.
  • It is expensive to contain a measles outbreak.

Most importantly, parents should understand that a measles vaccine (MMR) is the best way to protect your child from measles, and is especially important if there is a measles outbreak in your area or if you are traveling to an area with high rates of measles.

The rise in measles cases around the world has changed the recommendations for measles vaccination in the U.S. While children routinely get their first MMR vaccine at 12 months and a booster dose at 4 years if they are traveling overseas, infants should get their first dose as young as six months of age. Children who are at least 12 months old should get two doses of MMR, separated by at least 28 days.


  • CDC. Notifiable Diseases and Mortality Tables. MMWR. June 17, 2016, /65(23)
  • Manual for the Surveillance of Vaccine-Preventable Diseases (4th Edition, 2008)
  • Measles Cases and Outbreaks. CDC. 
  • The Pink Book: Epidemiology and Prevention of Vaccine-Preventable Diseases. Updated 11th Edition, (May 2009)
  • World Health Organization. Measles Fact Sheet. March 2017.