What to do if you’ve been exposed to measles

By Deidre McPhillips, CNN

(CNN) — The United States reported a record number of measles cases in 2025, and the virus continues to spread rapidly in the new year. At least ​171 measles cases have been reported in the first two weeks of 2026, according to data published Wednesday by the US Centers for Disease Control and Prevention – nearly as many as the average annual total in the 25 years since measles was declared eliminated.

Most of the new cases are concentrated in areas with large ongoing outbreaks — in the upstate region of South Carolina and along the Utah-Arizona state line — but the sheer scale of those outbreaks leaves the broader public at risk, even in places that aren’t currently reporting high numbers of cases.

As measles cases grow exponentially, it becomes harder to track every exposure, said Dr. Linda Bell, South Carolina’s state epidemiologist. People may also be out in the community without knowing that they’re infectious, and this can lead to unknown exposures.

Dozens of public exposure locations have been identified in South Carolina over the past week, Bell said Wednesday — at schools, churches, restaurants, shops and health care settings — but the health department doesn’t always publicize all of those exposure locations unless it can share specific details about the date and time of the occurrence.

Exposures can happen when people are visiting areas experiencing an outbreak, as happened with a North Carolina family who visited Spartanburg County, South Carolina, and when infected individuals travel, as in New Mexico, where the health department recently warned of possible measles exposure at a hotel in Albuquerque from someone visiting from South Carolina.

At least four major international airports in the US reported measles cases or potential exposures during peak holiday travel last month, and an infectious individual traveled through major cities in the Northeast on an Amtrak train last week.

“We’re going to see more of those exposures” because of falling vaccination rates and greater spread, said Dr. Jesse Hackell, a retired pediatrician and member of the American Academy of Pediatrics, but “vaccinating almost completely eliminates the risk of an exposure leading to disease.”

Here’s how to prepare for a possible measles exposure and how to respond if it happens.

Check your vaccination status

Measles is one of the most contagious diseases there is, but the measles-mumps-rubella (MMR) vaccine is extremely effective. One dose is 93% effective against measles, and the recommended second dose bumps that protection up to 97% — and the immunity is lifelong.

It’s generally recommended that children get their first dose around 12 months to 15 months of age and the second between ages 4 and 6, but that timeline can move earlier amid outbreaks — with the first dose given as young as 6 months. Older children and adults can get vaccinated at any time, too.

People who are vaccinated don’t have much to worry about, experts say.

“If you have immunity to measles, you will most likely just be directed to watch for symptoms as a precaution,” said Dr. Raynard Washington, director of the public health department in Mecklenburg County, North Carolina. “The vaccine should do what it is intended to do.”

For people who are not vaccinated when they’re exposed to the virus, there still is a chance to benefit from the protection the vaccine provides — but quick action is required.

An MMR vaccine given within 72 hours of exposure to measles may offer some protection or lead to milder illness. This timeframe is often before symptoms appear.

Contact your health care provider

People who know that they have been exposed to measles, or who are worried that they might have been exposed, should contact a health care provider.

Public health experts stress that folks should call ahead, rather than just showing up to doctor’s offices, emergency rooms or other health care clinics, to keep from infecting other people.

“Due to the exposures that have occurred in multiple health care settings, we remind anyone who needs medical care and knows or suspects that they may have measles, that they must notify a health care provider before visiting a health care facility. And if they have one available, they should consider wearing a mask when seeking care, to protect others in those settings from being exposed,” Bell said.

“We are focusing all of our efforts on containing the spread of the virus around the surveillance information that’s reported to us,” she said.

Dr. Stuart Simko, a pediatrician with Prisma Health who practices in upstate South Carolina, has treated multiple measles patients and consulted with many others about possible cases. He says that protocols reminiscent of the early Covid-19 days — including telehealth visits, masking and asking people to wait in the car — has helped prevent spread.

“We took our policies and the policies that Prisma developed for screening, and we revved that up. We took it to the next level,” he said. When his office called the state health department to report the measles cases, he said officials were happy to hear that no one else had been exposed as a result.

“The amount of work that goes into contact-tracing and figuring out who is exposed in the office and who’s had their vaccines — to me, that would be a nightmare,” Simko said. “I was really proud of our team for stepping it up and in a really fast manner and make adjustments on the fly.”

Watch for symptoms and monitor change

Early symptoms of a measles infection may make it appear like a different respiratory illness; it often starts with a fever, cough and runny nose.

The hallmark rash typically shows up a few days later, starting in the mouth and along the hairline and working its way down the body.

There is one other early indicator that someone might be sick with measles instead of a different respiratory virus: conjunctivitis, or pink eye.

“That’s something that would show up even maybe before the rash,” Hackell said. “So if you see that pattern, you should definitely talk to your pediatrician.”

There is no specific therapy to treat measles, so vigilance is key when monitoring and managing the symptoms, experts say, including regular check-ins with health care providers.

Simko met with his measles patients every couple of days through telehealth, watching to be sure they were staying hydrated and showing signs of improvement after a week or so.

“Most kids do OK with measles, but a few don’t, and there’s no real good way at the beginning to predict which child is going to be that way,” Hackell said.

Hospitalization may be necessary if there are signs of pneumonia or encephalitis, which is swelling of the brain.

Stay aware of the situation

“It’s important to know what is going on in your environment,” Hackell said. “I think it’s important that parents know what the vaccination rates are in their local schools.”

An exposure in a school with a high vaccination rate is much less likely to spread than in a school with a lower vaccination rate, and small differences in coverage matter. This awareness can help parents make decisions about their own behaviors and communicate relevant information to their health care providers if concerns arise.

“What you can’t plan for is the public exposures like airports, trains and things like that,” Hackell said. “What’s really critically important is that the local health department, the state health department and the CDC continue to monitor what’s going on and be very quick at announcing when there has been an outbreak.”

The State Carolina public health department shares two updates about the measles outbreak each week, and many other state and local health departments have issued notices about possible exposures in their area.

The public health department in Mecklenburg County, North Carolina, recently alerted the public that it had detected measles in the wastewater — a sign that someone with a measles infection had been present in the area even though no cases had been reported.

This notification also allowed the county health department to let residents know that same-day MMR vaccination was available through the Mecklenburg County Public Health Immunization Clinic and that the mobile unit would be onsite at Charlotte-Mecklenburg Schools locations through the end of the school year.

“Local public health is on the front line of response for this work. So if you have been exposed, or there’s a potential that there was an exposure, that is the first thing that we are responsible for doing,” Washington said. “In most cases, we’re able to directly notify individuals who were involved, and if we’re not, if there’s a situation where we’re not able to contact all those individuals, then we will send the public notice.”

Help prevent broader spread

Unvaccinated people who have been exposed to measles should stay home and away from others for 21 days after the exposure date.

A person who has measles can be infectious before they have any symptoms of the disease, and this quarantine period helps reduce the risk of continued spread during the incubation period.

In South Carolina, more than 400 people are in quarantine after known exposures, and the state health department has said that a significant share of cases have resulted from those in quarantine — an indication of just how important the public health practice is to interrupting spread.

But weeks of missed school or work and all of the associated costs can be avoided: People who have gotten both of their recommended MMR shots don’t have to quarantine.

“Vaccination is the best way for parents to have some confidence, even in the event of an exposure,” Hackell said.

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