The United States is currently experiencing a surge in measles cases. As of May 2, 2025, there have been a total of 935 confirmed measles cases across 30 states including Hawaii. Of these cases, 30% were under 5 years old, and another 38% were between the ages of 5 and 19 years old. The majority (96%) of cases were either unvaccinated or have unknown vaccination status for measles. In terms of outcomes, 121 cases (13%) have been hospitalized (23% of the hospitalizations were kids younger than 5 years old), and 3 cases have died.

Measles is an airborne, extremely infectious, and potentially severe rash illness. Before the measles vaccine was developed, around 48,000 people were hospitalized and around 400 – 500 people died each year from measles. Severe complications of measles can include hospitalization (1 in 5 cases), pneumonia (1 in 20 children), encephalitis (1 in 1000 children), and death (1 – 3 in 1000 children). Additional complications may include convulsions, intellectual disability, deafness, and a long-term fatal condition called subacute sclerosing panencephalitis (SSPE), which is a rare but fatal disease of the central nervous system that presents 7 – 10 years after recovering from a measles infection. Further, measles in pregnant women can lead to premature and low-birth-weight babies.

Since the development of the measles vaccine, there has been a drastic reduction in measles cases and deaths worldwide. In fact, measles was declared eliminated in the U.S. in 2000. However, measles cases and outbreaks are occurring again because of lower vaccination rates.

Symptoms of measles usually begin with fever, cough, runny nose, and red, watery eyes typically 11 – 12 days after exposure to someone with measles. These initial symptoms are then followed by a rash 3 – 5 days later. It’s important to know that a person with measles is infectious (can spread to other people) from about four days BEFORE the rash appears to about four days after the rash appears. Meaning, someone can be infectious before they know they are sick!

The best way to prevent measles is by getting vaccinated with the Measles, Mumps, Rubella (MMR) vaccine. The MMR vaccine is effective and safe. If you are unsure on your or your children’s vaccination status, follow up with your personal physician and/or your children’s pediatrician. Being vaccinated doesn’t just protect you; it also protects those around you. For various reasons, some people can’t get the MMR vaccine. But when enough people within our communities are vaccinated, these unvaccinated people can be protected by “herd immunity” because those around them are vaccinated (or had the disease) and are not bringing the illness into the community. To establish herd immunity, a community needs at least a 95% vaccination rate. Unfortunately, the vaccination rate in

Hawaii is only 89.8%. Some smaller subsets within Hawaii may have even lower vaccination rates. So, our Hawaii community is currently at risk.

Additional steps to help reduce the spread of measles include: staying home when ill, washing your hands often with soap and water, and covering your cough and sneeze. It’s important to also wear a mask if you need to leave your house for medical care.

If you’ve been in contact with someone with measles, or you are starting to have symptoms of measles, call your doctor right away before you go to the clinic or emergency room. Please make sure to tell them you are concerned about measles so they can assess you in an area with no other patients around (to avoid spreading measles within the medical facility).

Maui currently doesn’t have measles cases, but this fact can unfortunately change at any time. So, this is the perfect time to make sure you and your family (especially your children) are protected. Follow up with your medical provider to find out if you are fully vaccinated against measles or to get vaccinated so you can be protected. For more information about measles visit www.cdc.gov/measles/.

Kristin Mills is the Public Health Educator for the Maui District Health Office.