What's Up with Measles, and Should You be Worried?

In 2000, the U.S. government declared that measles had been eliminated. But the virus has made a comeback in the U.S., with the number of cases reported so far this year the highest in 25 years.

According to the U.S. Centers for Disease Control and Prevention (CDC), as of July 30, 2026, 2,371 confirmed measles cases have been reported. That is already higher than the 2,289 cases reported during all of 2025 and is the country’s highest annual total since 1991. And because 2026 still has five months to go, the count will probably continue to rise.

Resource editors spoke with David Mishkin, M.D., emergency medicine physician and medical director of express symptom management at Baptist Health Herbert Wertheim Cancer Institute, assistant medical director of emergency medicine at Baptist Health Baptist Hospital and medical director of telemedicine for Baptist Health Urgent Care.

Dr. Mishkin offered his specialized insights on the surge in U.S. measles cases this year and what people need to know about the once-vanquished virus.

RESOURCE: What is measles, and why is it considered especially contagious?

Dr. Mishkin: Measles is an acute respiratory infection caused by the measles virus. It spreads through the air when an infected person coughs, sneezes or even breathes. What makes measles particularly concerning is how efficiently it spreads. From an emergency physician's perspective, measles is one of the few infectious diseases where a single undiagnosed patient can expose dozens of people in a healthcare setting. If someone without immunity is exposed, approximately 90% will become infected. That level of contagiousness is what makes rapid recognition and isolation so important.

RESOURCE: What are the earliest symptoms, and how does the illness typically progress?

Dr. Mishkin: Measles usually begins with a high fever, cough, runny nose and red, watery eyes. We often refer to these as the “three C’s”: cough, coryza and conjunctivitis. Patients may initially feel as though they have a significant respiratory virus. Small white spots known as Koplik spots may also appear inside the mouth. Two to four days after the first symptoms begin, the characteristic rash appears, consisting of flat red spots, sometimes with small, raised bumps. It typically begins at the hairline or on the face and then spreads downward to the neck, trunk, arms, legs and feet. Fever often becomes higher as the rash develops.

RESOURCE: How can someone distinguish early measles symptoms from a cold, influenza, COVID-19 or another viral illness?

Dr. Mishkin: Early on, it can be difficult to distinguish measles from other viral illnesses because the symptoms overlap. What raises our concern is the combination of symptoms—high fever, cough, runny nose and red, watery eyes, followed by a rash that starts on the face and spreads downward. Recent travel, known exposure, or lack of vaccination also substantially increases suspicion.

RESOURCE: How long after exposure do symptoms usually develop, and when is an infected person contagious?

Dr. Mishkin: Measles symptoms usually begin seven to 14 days after exposure, with an average incubation period of about 11 to 12 days. A person with measles is generally considered contagious from four days before through four days after the rash appears and should remain isolated for at least four full days after rash onset. Immunocompromised patients may remain contagious longer. Household members should promptly confirm their immunity, follow instructions from the health department and avoid bringing the patient into shared public spaces.

RESOURCE: What warning signs should parents and other patients watch for?

Dr. Mishkin: Parents should seek medical advice for high fever, worsening cough, red eyes and a rash, particularly after travel or a known exposure. Warning signs include difficulty breathing, dehydration, confusion, seizures, severe headache or symptoms that are rapidly worsening.

RESOURCE: Is there a specific treatment for measles or is patient care primarily focused on managing symptoms and complications?

Dr. Mishkin: There is no routinely approved antiviral treatment that cures measles. Care is primarily supportive and may include fluids, fever management, nutritional support and treatment of complications such as pneumonia, dehydration or secondary bacterial infections. Some patients require hospitalization. Vitamin A may be recommended for children with measles, but it must be given at the proper dose under a clinician’s supervision.

RESOURCE: When does measles require emergency medical attention?

Dr. Mishkin: Emergency evaluation is appropriate for difficulty breathing, severe dehydration, confusion, seizures, inability to awaken normally or any rapidly deteriorating condition. Infants, pregnant women and immunocompromised patients should be evaluated promptly because they are at higher risk for these complications.

RESOURCE: What have emergency physicians been advised to watch for as measles cases increase?

Dr. Mishkin: Emergency physicians are maintaining a higher level of suspicion for patients with fever, rash and respiratory symptoms. Vaccination history, travel history and potential exposures are all important. Early recognition is critical to prevent additional exposures.

RESOURCE: What happens when a patient with suspected measles arrives in an emergency department?

Dr. Mishkin: Patients are immediately isolated, ideally in an airborne infection isolation room. Staff wear appropriate respiratory protection, testing is initiated and infection prevention teams and public health officials are notified.

RESOURCE: If someone suspects measles, should they go directly to an emergency department or call ahead first?

Dr. Mishkin: Unless it is a life-threatening emergency, patients should call ahead before arriving to notify emergency department staff. This allows our care teams to safely prepare for the patient's arrival and reduce the risk of exposing others.

RESOURCE: The U.S. declared measles eliminated in 2000. How did we get to today's increase?

Dr. Mishkin: Measles was eliminated as an endemic disease in the U.S. but it continues to circulate internationally. Imported cases combined with pockets of declining vaccination coverage and gaps in community immunity have allowed measles to spread much more easily once introduced.

RESOURCE: How significant is the current increase?

Dr. Mishkin: The current increase is the largest the United States has experienced in decades and reflects a substantial rise compared with recent years.

RESOURCE: Why should people in South Florida be concerned?

Dr. Mishkin: South Florida is an international gateway with frequent domestic and international travel. Imported cases can quickly lead to local transmission if they reach susceptible individuals.

RESOURCE: Other than being unvaccinated, what increases the risk of severe complications?

Dr. Mishkin: Young children, pregnant women and people with weakened immune systems are at greatest risk for serious complications from measles, such as pneumonia and encephalitis.

RESOURCE: What would you say to a parent who believes measles is simply a routine childhood illness?

Dr. Mishkin: Before vaccination, measles hospitalized tens of thousands of Americans each year and caused hundreds of deaths annually. While many children recover, measles can cause severe complications, permanent neurologic injury and death, even in previously healthy children.

RESOURCE: What is the single most important message you want readers to understand?

Dr. Mishkin: Measles is highly contagious but also highly preventable. Staying up to date on MMR vaccination and recognizing symptoms early are the best ways to protect individuals, families and our community.

If you think your or someone in your family has been exposed to measles, click here to find a Baptist Health Emergency Department near you.