Measles outbreaks are widening across the United States, pushing the national case count to its highest level in more than three decades.
Maryland became the latest state to escalate its response on Monday, declaring a measles outbreak across three counties after health officials confirmed 14 additional infections. The new cases raise Maryland’s 2025 total to 31.
Health officials said 27 of the infections have emerged within the past six weeks, and every one of those patients was unvaccinated against measles.
The confirmed Maryland measles cases have been reported in several counties: 13 in St. Mary’s, eight in Carroll, five in Cecil and one in Charles.
“Measles is highly contagious and we are actively working with healthcare professionals and local health departments to support impacted communities, respond to cases and mitigate further spread,” Maryland Department of Health Secretary Dr. Meena Seshamani said.
She added that people who are fully vaccinated remain at low risk, urging residents to help protect infants and others most vulnerable to severe illness. “Checking your vaccination status and getting vaccinated if you are not up-to-date is the simplest and most effective way to do that,” Seshamani said.
Maryland officials have not identified any public exposure sites tied to the 14 newly confirmed cases. In Iowa, however, a growing measles outbreak may have exposed thousands of people at nearly a dozen locations statewide.
The outbreak in southern Iowa has grown again, with two newly confirmed cases bringing the total there to 17.
Measles, which is highly infectious, is characterized by cough, fever, a distinctive blotchy rash that starts on the face before spreading down the body (stock image)
And there are now nine locations where people may have been exposed to the virus, including Natural Grocer’s Clive and Menards in Clive, Iowa; Vero Health Center and Office Depot in West Des moines, Iowa; Menards in Des Moines, Iowa; Pizza Ranch in Ottumwa, Iowa; and Wells Hometown Drug, JR Feed and Supply anad Sunnyside Grocery, in Bloomfield, Iowa.
The outbreaks come just as the first deaths of 2026 from the measles were reported on Tuesday.
Officials reported the two deaths occurred in unvaccinated patients in Pennsylvania. They are the state’s first measles deaths in 35 years.
The Pennsylvania Department of Health confirmed both individuals were residents of Lancaster County, about 60 miles outside of Philadelphia. No additional details about those who died were provided.
‘My deepest sympathies are with the loved ones who are facing this unimaginable loss,’ Dr Debra Bogen, the state’s secretary of health, said in a statement.
‘Because measles was largely eliminated in the Commonwealth for more than three decades, people are not familiar with this disease and don’t fully understand the potential severity of the illness.’
Pennsylvania has recorded 393 measles cases across 28 counties so far in 2026. Nationwide, cases have reached their highest in more than three decades.
As of August 20, the CDC has recorded 2,777 confirmed cases of the measles. This is the most cases recorded since 1991, which saw 9,643 cases.
Last year, there were 2,289 cases and three deaths, according to the CDC.
The vast majority of cases in both 2025 and 2026 were in individuals who had not received both doses of the measles, mumps and rubella (MMR) vaccine.
The shot is typically given once between ages 12 and 15 months and again between ages four and six. Two doses slash the risk of measles infection by 97 percent, according to the CDC.
For unvaccinated people, nine in ten of those exposed to the virus will get infected.
‘We want to ensure every Pennsylvanian has the information they need to protect themselves, their loved ones and their communities,’ Bogen said.
‘As a physician, I want to make sure that people understand that the MMR vaccine is safe and provides the best protection we have against measles.’
Measles, which is highly infectious, is characterized by cough, fever, a distinctive blotchy rash that starts on the face before spreading down the body and tiny white spots inside the mouth called Koplik spots.
The virus spreads through direct contact with infectious droplets or through the air. Patients with a measles infection are contagious from four days before the rash through four days after the rash appears. Enclosed areas like airports and planes are extremely risky locations for disease transmission.
It first invades the respiratory system, then spreads to the lymph nodes and throughout the body. As a result, the virus can affect the lungs, brain and central nervous system.
While measles sometimes causes milder symptoms, including diarrhea, sore throat and achiness, it leads to pneumonia in roughly six percent of otherwise healthy children, and more often in malnourished children.
Though the brain swelling that measles can trigger is rare, occurring in about one in 1,000 cases, it is deadly in roughly 15 to 20 percent of those who develop it, while about 20 percent are left with permanent neurological damage, such as brain damage, deafness or intellectual disability.
Measles also severely damages a child’s immune system, making them susceptible to other potentially devastating bacterial and viral infections they were previously protected against.
Before MMR vaccines became available in the 1960s, measles caused epidemics with up to 2.6 million global deaths every year. By 2023, that number had fallen to roughly 107,000 deaths.
Nationwide, 92.4 percent of kindergarteners are fully vaccinated against measles, below the CDC’s 95 percent threshold for herd immunity. In Pennsylvania, the MMR vaccination rate is 94.6, while rates in Maryland and Iowa are 96 and 90 percent, respectively.
Exemptions are also on the rise at 4.2 percent, up 17 percent from 1.6 percent just over a decade ago.
