Measles was declared eliminated from the United States in 2000, but travelers continue to bring it in from abroad. There were at least 349 cases that occurred in 17 outbreaks in 2018. Currently, there are outbreaks in Texas, New Jersey, New York and Washington. Washington State has declared a state of emergency as there have been 66 new cases of measles thus far in 2019.

Should you be concerned? The answer is both “yes” and “no.”

The answer “no” is because if you’re reading this, it’s unlikely you’re at personal risk because you were either vaccinated or had measles as a child.

But, if you have young children or infants in your family, the answer is “yes.” They’re not protected until they have had two doses of the vaccine. The first dose is given after the first birthday and the second is usually given after the child turns 4. That means there are a lot of infants and toddlers who are either unprotected or only partially protected. Children with health conditions such as cancer, which impairs their immune system, are especially vulnerable to the disease since they cannot be vaccinated.

Measles is a nasty disease and highly contagious. It spreads by touch or breathing in the same air as an infected person. The virus stays alive in the air or an infected surface for up to two hours. If you’re not immune to the virus then the chances of becoming ill with measles is about 90 percent if you’re near someone who has the infection. This doesn’t even need to be with direct contact — you can just be in the same room.

A person is usually sick with fever, cough, runny nose and a distinctive rash that starts about four days after the initial symptoms. A person is contagious as soon as they have the first symptom. This means people can spread the disease before knowing they have measles.

There’s reason for everyone to be concerned about the measles outbreaks. Vaccination eliminated measles from the United States. Because measles is one of the most contagious illnesses known, it’s the proverbial canary in the coal mine. Outbreaks indicate vaccination rates falling to the point that herd immunity is failing. Children who don’t get the measles vaccine are unlikely to get other vaccines as well. We will continue to see large outbreaks of other vaccine preventable diseases like whooping cough, mumps and chickenpox until vaccination rates increase.

Vaccine preventable diseases cost us all. These illnesses increase medical costs, lead to lost time at school and work and, most importantly, may lead to permanent disability and even death.

Yes, we should be concerned by measles outbreaks.

Vaccine Smarts is written by Sealy Institute for Vaccine Sciences faculty members Dr. Megan Berman, an associate professor of internal medicine, and Dr. Richard Rupp, a professor of pediatrics, at the University of Texas Medical Branch. Have questions about vaccines? Send them to

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