Getting Ahead of Measles: Understanding How It Spreads and Why Outbreaks Are on the Rise

The United States is struggling to contain measles and is at risk of losing “elimination” status achieved in 2000. Measles (rubeola) is one of the most contagious of all infectious diseases and can spread rapidly among unvaccinated people, requiring immediate response. In recent decades, this preventable disease has continued to cause outbreaks due to low vaccination levels, making it a growing concern for all. As of March 20, 2025, there have been 378 confirmed cases of measles in the United States, exceeding the number of measles cases in all of 2024.¹ To get ahead of this outbreak, it’s important to understand the virus and how to prevent it.

How Measles Spreads

Measles is a highly contagious virus that can spread easily. One person with measles can, on average, infect between 12 and 18 other people in an unvaccinated population.²

Measles is very contagious because it can be spread through the air, so when an infected person coughs, sneezes, talks or even breathes, they spread the virus. The measles virus can linger in the air for up to two hours and can settle on surfaces and objects. That means a person with measles can infect another person even after leaving a room, as susceptible individuals can simply breathe in the virus from the air or touch a contaminated object and then touch their eyes, nose or mouth, and become infected. The Centers for Disease Control and Prevention (CDC) notes that if a person has measles, “up to 90% of the people close to you, who are not immune, will also become infected.”³

Symptoms and Health Implications

Symptoms tend to appear 1 to 2 weeks after exposure. The most common symptoms are high fever (even as high as 104° F), cough, runny nose, red and watery eyes and a rash. Measles can also have serious complications: for children younger than five years or those with weakened immune systems, measles can cause complications like ear infections, diarrhea and pneumonia or encephalitis, which can result in death.⁴ Long term, measles can also cause “immune amnesia,” where our bodies forget how to fight known infections, making individuals more susceptible to other illnesses.

What’s Happening Now?

There have been three outbreaks in the United States in 2025. The largest is in West Texas, where 100+ cases have been identified, and one child has died. Subsequent cases have been identified across 16 jurisdictions and 93% are outbreak-associated.

The 378 cases in 2025 point to worrying trends:

• • 95% of the cases were in those unvaccinated or with an unknown vaccine status.
• • Measles is impacting children and teens, with 75% of cases in people 19 years or younger.
• • 64 people have been hospitalized, most of whom were under the age of five.⁵

Herd immunity is where enough of the population is immune (e.g., unable to be infected/spread the disease) and can protect those unable to be vaccinated, such as infants under the age of 12 months. To maintain herd immunity, a minimum of 95% of the U.S. population needs to be vaccinated against measles.⁶ Current vaccination coverage among kindergarteners decreased from 95.2% in 2019/2020 to 92.7% in 2023/2024.⁷ For adolescents 13-17 years old, 91.9% are fully vaccinated. Due to decreasing vaccination levels, the U.S. is losing its capacity to prevent highly contagious outbreaks through herd immunity and vaccination.

For Cleaning Professionals

Beyond vaccination, we can help prevent the spread of measles through effective cleaning and disinfection. While the primary route of transmission is through the air, measles can also be spread from contaminated environmental surfaces and objects, which can then lead to infection through touching the contaminated objects and then one’s eyes, nose or mouth. While this outbreak continues, it’s important to use EPA-registered disinfectants effective against measles, especially on high-touch surfaces.

Additional Resources

This highly infectious virus can be challenging to control, but we have the tools we need to succeed, such as effective vaccines, masks, cleaning/disinfection practices and good air filtration. We all play a critical role in helping to curb ongoing outbreaks and cleaning professionals are an especially vital part of this team effort to create a safer environment for everyone. Using tried-and-true methods, we can stop the spread of measles together.

If you’re looking for helpful resources to understand the disease, how it spreads and how you can get ahead of it, check out the following sources:

• Measles Pathogen Education Sheet
• CDC’s page on the current outbreak and cases