United States: More than 1,100 measles cases have surged across the United States this year, creating invisible hazards for people not just in medical waiting rooms, but also in high-traffic spaces like Shakira’s concert in New Jersey, a mall in Minnesota, a Buc-ee’s in Texas, and terminals of major airports.
The US Centers for Disease Control and Prevention (CDC) cautioned in an updated advisory that measles transmission thrives in travel-related corridors — including bustling airports, packed trains, noisy tourist spots, and gatherings that draw large crowds. Infected passengers, even with no obvious symptoms, often bring the virus back to their hometowns, igniting chain reactions in communities with low immunity.
For many Americans, such outbreaks feel alien. Measles had been declared eliminated from US soil in 2000, thanks to meticulous immunization efforts. That year saw only 85 infections, all of which were linked to international exposure. But this year, at least 1,157 infections have been recorded, per a CNN count drawing from state health departments — the highest number since 2019’s 1,274-case tally.
The lion’s share of this year’s cases have emerged from a sweeping, multi-state flare-up rooted in West Texas. While health officials report signs of tapering in that region, concerns are growing that the flood of summer travel could scatter the virus even further, warned Lori Tremmel Freeman, head of the National Association of County and City Health Officials.
In the outbreak’s ground zero — Gaines County — many have either contracted measles and gained natural immunity or received vaccinations after the crisis unfolded. Still, Freeman warned that summer migration could fan new embers. “Travel volumes are about to explode,” she said. “And wherever these groups travel, they may unknowingly drag measles along.”
Vaccine Guidance Sees Subtle Shifts
The CDC now insists that anyone embarking on international journeys should have two documented doses of the measles-mumps-rubella (MMR) vaccine. Infants aged between 6 and 11 months — who normally wouldn’t receive their first dose until age one — are advised to get an early, additional shot.
Dr. Peter Hotez, co-director of the Texas Children’s Hospital Center for Vaccine Development, explained that this updated advice aligns with guidance from Texas state health leaders in ten counties severely affected by the virus this year. “Instead of the routine two doses, some infants may now receive three. One early, one at the usual 12–15 months, and another between ages 4–6,” he noted.
Still, he emphasized the safety of this extra jab: “The MMR vaccine is among the safest immunizations we’ve ever had in medicine.”
Adults born before 1957 are generally excluded from needing the MMR vaccine, based on the assumption that they were naturally exposed to measles during earlier epidemics. Exceptions are made, however, for healthcare professionals in outbreak zones — who are urged to get two doses regardless of age.
Hotez also hinted that vaccine protocols could shift further, depending on how this outbreak evolves. Remaining tuned to local health bulletins is essential.
Certain groups — including pregnant women, newborns under six months, and people with deeply compromised immune systems — are advised against taking the MMR shot.
Tailored Measures for the Vulnerable
Though the likelihood of encountering measles is still relatively low, those who can’t receive the vaccine should have candid discussions with their doctor about travel risks, advised Dr. Scott Roberts, associate medical director for infection control at Yale School of Medicine.
“Risk tolerance really varies based on where you’re going and what treatments are accessible there,” Roberts said. For example, the availability of immunoglobulin — antibodies used to cushion the blow of exposure — could change the equation. These are typically administered in hospital settings to individuals with weakened immunity following contact with the virus.
Proactive Steps for Travelers
Historically, US-based measles flare-ups have often stemmed from non-immune American travelers catching the disease overseas and inadvertently igniting domestic spread upon return. Although some cases do stem from foreign visitors, they make up the minority.
Currently, no country mandates proof of MMR vaccination to cross borders. Still, Roberts suggests travelers verify their immune status well in advance. Immunity could stem from a prior infection, a verified lab test, birth before 1957, or written proof of two MMR doses.
Ideally, this should be done at least six weeks prior to travel. It’s not just about the shots — full protection also needs a two-week window after the second dose to fully kick in.
The MMR vaccine is roughly 97% effective. If a fully vaccinated traveler thinks they’ve been exposed, Roberts reassures that symptoms, if they appear at all, are usually far milder.
However, for those who are unvaccinated and exposed, time is crucial. “You may still benefit from post-exposure actions like a quick vaccine dose or immunoglobulin,” Roberts said.
Beyond checking immune status, Roberts recommends taking routine travel precautions — such as bringing necessary medications, researching nearby hospitals, and packing a basic first aid kit. He also advises travelers to check country-specific health advisories on the CDC website for potential updates on vaccinations.
In crowded, enclosed settings — especially for those who are immunocompromised — wearing a mask, practicing hand hygiene, and maintaining distance from sick individuals are all strong lines of defense against measles and other viruses, such as the flu or COVID-19.
Measles’ Potency Demands Respect
Few viruses are as transmissible as measles. Roberts recounted a striking case from a decade ago: four travelers were infected by just one person, all at the same airport gate. “It’s a reminder of how explosive this virus is,” he said. “You don’t even need close contact. Shared air is enough.”
Dr. Hotez echoed the gravity of the situation. “Back in the 1980s, measles was the top child-killer worldwide, claiming 3 million lives each year,” he said. “Thanks to global vaccine drives like GAVI, that number has fallen to around 100,000 — but that’s still far too many. What we’re witnessing in West Texas is grim — 10% to 20% of kids are ending up in hospitals with complications like pneumonia or neurological damage.”
Already, over 90 children have been hospitalized in Texas this year, with two tragic deaths.