The U.S. has more than double the number of measles cases it saw in all of 2024, with Texas reporting the majority of them: nearly 500. The cases include two young elementary school-aged children who were not vaccinated and died from measles-related illnesses near the epicenter of the outbreak in rural Texas, which led Health Secretary Robert F. Kennedy Jr. to visit the community.

Other states with active outbreaks — defined as three or more cases — include New Mexico, Kansas, Ohio and Oklahoma. The virus has been spreading in undervaccinated communities. The third person who died was an adult in New Mexico who was not vaccinated.

The multi-state outbreak confirms health experts’ fears that the virus will take hold in other U.S. communities with low vaccination rates and that the spread could stretch on for a year. The World Health Organization said last week that cases in Mexico are linked to the Texas outbreak.

Measles is caused by a highly contagious virus that’s airborne and spreads easily when an infected person breathes, sneezes or coughs. It is preventable through vaccines, and has been considered eliminated from the U.S. since 2000.

Here’s what else you need to know about measles in the U.S.

How many measles cases are there in Texas and New Mexico?

Texas’ outbreak began more than two months ago. State health officials said Friday there were 59 new cases of measles since Tuesday, bringing the total to 481 across 19 counties — most of them in West Texas. The state also logged 14 new hospitalizations, for a total of 56 throughout the outbreak.

More than 65% of Texas’ cases are in Gaines County, population 22,892, where the virus stated spreading in a close-knit, undervaccinated Mennonite community. The county now has logged 315 cases since late January — just over 1% of the county’s residents.

New Mexico announced six new cases Friday, bringing the state’s total to 54. New Mexico health officials say the cases are linked to Texas’ outbreak based on genetic testing. Most are in Lea County, where two people have been hospitalized, and two are in Eddy County.

Thursday’s death in Texas was an 8-year-old child, according to Kennedy. Health officials in Texas said the child did not have underlying health conditions and died of “what the child’s doctor described as measles pulmonary failure.” A child died of measles in Texas in late February — Kennedy said age 6 — and New Mexico reported its first measles-related death in an adult on March 6.

How many cases are there in Kansas?

Kansas has 24 cases in six counties in the southwest part of the state as of Wednesday. Kiowa and Stevens counties have six cases each, while Grant, Morton, Haskell and Gray counties have five or fewer.

The state’s first reported case, identified in Stevens County on March 13, is linked to the Texas and New Mexico outbreaks based on genetic testing, a state health department spokesperson said. But health officials have not determined how the person was exposed.

How many cases are there in Oklahoma?

Cases in Oklahoma remained steady Friday: eight confirmed and two probable cases. The first two probable cases were “associated” with the West Texas and New Mexico outbreaks, the state health department said.

A state health department spokesperson said measles exposures were confirmed in Tulsa and Rogers counties, but wouldn’t say which counties had cases.

How many cases are there in Ohio?

Ohio reported one new measles case Thursday in west-central Allen County. Last week, there were 10 in Ashtabula County in the northeast corner of the state. The first case was in an unvaccinated adult who had interacted with someone who had traveled internationally.

In central Ohio, Knox County officials reported two new measles cases in international visitors, for three cases in international visitors total. Those cases are not included in the state’s official count because they are not in Ohio residents. A measles outbreak in central Ohio sickened 85 in 2022.

Where else is measles showing up in the U.S.?

Measles cases also have been reported in Alaska, California, Colorado, Florida, Georgia, Kentucky, Maryland, Michigan, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island, Tennessee, Vermont, and Washington.

The U.S. Centers for Disease Control and Prevention defines an outbreak as three or more related cases. The agency counted six clusters that qualified as outbreaks in 2025 as of Friday.

In the U.S., cases and outbreaks are generally traced to someone who caught the disease abroad. It can then spread, especially in communities with low vaccination rates. In 2019, the U.S. saw 1,274 cases and almost lost its status of having eliminated measles. So far in 2025, the CDC’s count is 607.

Do you need an MMR booster?

The best way to avoid measles is to get the measles, mumps and rubella (MMR) vaccine. The first shot is recommended for children between 12 and 15 months old and the second between 4 and 6 years old.

People at high risk for infection who got the shots many years ago may want to consider getting a booster if they live in an area with an outbreak, said Scott Weaver with the Global Virus Network, an international coalition. Those may include family members living with someone who has measles or those especially vulnerable to respiratory diseases because of underlying medical conditions.

Adults with “presumptive evidence of immunity” generally don’t need measles shots now, the CDC said. Criteria include written documentation of adequate vaccination earlier in life, lab confirmation of past infection or being born before 1957, when most people were likely to be infected naturally.

A doctor can order a lab test called an MMR titer to check your levels of measles antibodies, but health experts don’t always recommend this route and insurance coverage can vary.

Getting another MMR shot is harmless if there are concerns about waning immunity, the CDC says.

People who have documentation of receiving a live measles vaccine in the 1960s don’t need to be revaccinated, but people who were immunized before 1968 with an ineffective measles vaccine made from “killed” virus should be revaccinated with at least one dose, the agency said. That also includes people who don’t know which type they got.

What are the symptoms of measles?

Measles first infects the respiratory tract, then spreads throughout the body, causing a high fever, runny nose, cough, red, watery eyes and a rash.

The rash generally appears three to five days after the first symptoms, beginning as flat red spots on the face and then spreading downward to the neck, trunk, arms, legs and feet. When the rash appears, the fever may spike over 104 degrees Fahrenheit, according to the CDC.

Most kids will recover from measles, but infection can lead to dangerous complications such as pneumonia, blindness, brain swelling and death.

How can you treat measles?

There’s no specific treatment for measles, so doctors generally try to alleviate symptoms, prevent complications and keep patients comfortable.

Why do vaccination rates matter?

In communities with high vaccination rates — above 95% — diseases like measles have a harder time spreading through communities. This is called “herd immunity.”

But childhood vaccination rates have declined nationwide since the pandemic and more parents are claiming religious or personal conscience waivers to exempt their kids from required shots.

The U.S. saw a rise in measles cases in 2024, including an outbreak in Chicago that sickened more than 60.

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According to the California Department of Public Health, three confirmed measles cases were reported in February, and five more as of March 27. In 2024, there were 15 measles cases throughout the year, they said. Though measles cases have increased in the United States, there are no suspected or confirmed measles cases in Riverside County as of April 1, according to the health officials with Riverside University Health System — Public Health.

“Residents should be aware of the benefits of vaccination and provided with education about the signs and symptoms of the disease,” County Public Health Officer Dr. Jennifer Chevinsky said.

According to the county health database, the last measles case in Riverside County was in 2018. Still, residents can take some actions to reduce the risk of measles in our communities, she advised.

“Vaccination remains the best way to protect yourself and our community against measles,” Chevinsky said. “Roughly 90% of those unvaccinated and exposed to measles will contract the disease.” She shared some tips on the disease, which can be highly contagious and dangerous in some cases.

Measles is a severe and highly infectious disease that can be spread through the air via droplets when a person breathes, talks, coughs, or sneezes.

For protection, the Centers for Disease Control and Prevention (CDC) recommends two doses of MMR (measles, mumps, rubella) vaccine for:

• Children: one dose at 12 months of age and another at 4-6 years.
• Older children, adolescents and adults without documented doses of MMR vaccine.

Additionally, if you are an adult born after 1957, one dose of live measles vaccine is sufficient to be considered protected from measles. Still, certain adults may need two doses.

Adults who are going to be in a setting that poses a high risk for measles transmission (e.g., healthcare providers) should make sure they have had two doses separated by at least 28 days.

Vaccination with one dose of MMR is also recommended for infants as young as 6 months old before international travel to reduce the risk of contracting measles while traveling to countries where measles is more common.

What are the symptoms of measles?

Symptoms of measles can include:

• initial fever that lasts a couple of days,
• followed by a cough,
• a runny nose,
• conjunctivitis (pink eye),
• a prickly red rash.

“There are many different kinds of rash illnesses that can appear similar to measles, so it’s important to consult with a healthcare provider to ensure an accurate diagnosis, which often requires testing. The public health department follows up on any instances where there may be concern for measles or other transmissible diseases of concern,” Chevinsky said in a recent news release.

“Typically, a rash will appear on the face, along the hairline, and behind the ears. It then spreads down to the rest of the body. Infected people can spread measles from about four days before their rash starts to four days afterwards.

“Symptoms typically will be observed 10–14 days after exposure to the virus. A prominent rash is often the most visible symptom. Complications of measles can include ear infections, hospitalization, pneumonia, swelling of the brain, and, in some instances, death. “

When To Ask Your Doctor:

Contact your healthcare provider if you or a loved one are experiencing a rash, illness, or believe you may have been exposed to measles, particularly after international travel or travel to a place with ongoing measles outbreaks, according to the Riverside University Health System.

“If you seek care through an emergency department or urgent care for a rash illness, it is important to call ahead so the health facility can take appropriate precautions.

What About Vaccines?

“To get vaccinated, talk to your healthcare provider or visit one of Public Health’s upcoming vaccine clinics. All clinics accept walk-in appointments. Cost and eligibility vary. For questions and clinic locations, please call (951) 358-7125 or visit www.ruhealth.org/vaccineclinics.

Learn more about measles here.

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