Measles is back in a big way — and it’s catching some doctors off guard.
In North Carolina, hospital staff took a staggering two hours and 20 minutes to isolate 7-year-old twin brothers who arrived at an Asheville ER last month with fever, cough, rash, pink eye and cold-like symptoms, KFF Health News reports.
The boys were later diagnosed with measles, but not before they exposed at least 26 other people inside the hospital to the life-threatening virus.
Experts say the troubling episode highlights a striking reality: Many US clinics and hospitals have little to no real-world experience with measles.
“The generation of physicians who are currently, for the most part, treating patients haven’t actually seen what a measles case looks like other than from a textbook or a video,” Dr. Andy Lubell, chief medical officer of True North Pediatrics in Pennsylvania, told the New York Times last year.
Measles was declared eliminated in the United States in 2000 following widespread adoption of the vaccine, a public health triumph that cut cases from roughly 3 to 4 million annually to about 180, according to the CDC.
But that hard-won victory is slipping.
In the Tar Heel State alone, health officials have confirmed at least 20 measles cases since mid-December. Across the country, more than 3,000 infections have been reported since the start of 2025, though the actual number is likely much higher.
Part of the challenge, experts say, is that measles doesn’t always look like measles — at least not at first.
“In the middle of winter right now, measles looks like every other viral respiratory infection that kids come in with,” Patsy Stinchfield, a former president of the National Foundation for Infectious Diseases and a nurse practitioner, told KFF Health News.
Early symptoms, such as fever, dry cough, runny nose and red, watery eyes, can easily be mistaken for the flu or a bad cold.
And by the time the telltale rash appears, the infected person has already been contagious for four days, potentially exposing classmates, coworkers, family members and entire hospital waiting rooms without even realizing it.
The virus spreads primarily through the air via respiratory droplets when an infected person coughs or sneezes. Even after a patient leaves, it can linger in a room for up to two hours, putting anyone who enters the space at risk.
“Once you get exposed to measles, the incubation period can be up to 21 days,” Dr. Erica Kaufman West, director of infectious diseases in the department of science, medicine and public health at the American Medical Association, said in an interview with the organization.
“It’s three weeks where you have to wait, watch and wonder if you’re going to develop symptoms if you don’t have immunity.”
If you haven’t gotten the vaccine, your odds aren’t great.
One person with measles can infect up to 18 others in an unvaccinated population, according to UCLA Health. Compare that to COVID-19, which typically spreads to just one to three people.
“It can be really hard to control from an infection-prevention and public health standpoint, given how contagious it is,” said Dr. Sanchi Malhotra, medical director of pediatric infection prevention for UCLA Mattel Children’s Hospital.
Health experts say vaccination remains the most powerful defense against the virus. Two doses of the Measles, Mumps and Rubella (MMR) vaccine are about 97% effective at preventing infection.
“Take the vaccine, please,” Dr. Mehmet Oz, the administrator for Centers for Medicare and Medicaid Services, told CNN’s “State of the Union.” “We have a solution for our problem.”
And yet, vaccination rates are falling.
Coverage among US kindergartners has dropped from 95.2% in the 2019–2020 school year to 92.5% in 2024–2025, below the level experts say is needed to protect the community from outbreaks, according to the CDC.
The effects are already being felt.
About 96% of measles cases reported so far this year have occurred in unvaccinated people. More than 80% involve children and teens, with roughly one in four cases affecting children under 5.
The consequences can be severe. For every 1,000 children infected, one may develop encephalitis — a dangerous swelling of the brain — and up to three may die.
Last year, three people in the US died from measles: two children in Texas and one adult in New Mexico. All were unvaccinated.
With the US reporting more than 1,100 cases in the first two months of 2026 alone, experts warn that additional fatalities are likely on the horizon.
“When more people are choosing not to vaccinate their children, you’re going to see more disease, more suffering, more hospitalization and more death,” Dr. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, told CNN. “And it is unconscionable.”
