Greetings, Durham!

I am Dr. Rodney Jenkins, Public Health Director for Durham County Department of Public Health. I’m pleased to be the guest columnist for the week and provide an important update on the measles, a disease that has recently resurfaced. I will share more about the disease, its evolution and how you can protect yourself, your family and your community from this highly contagious virus.

Measles in the United States and the Vaccine

Before the introduction of the first measles vaccine in 1963, around 500,000 cases of measles were reported to health authorities annually, with an estimated 3 to 4 million people infected every year in the United States. If you had not already had the measles, infection was nearly universal. Almost every child got the measles before they reached adulthood.

The measles vaccine, later combined into the measles, mumps, and rubella (MMR) vaccine, dramatically reduced measles infections after 1963. In 1989, the second dose of the MMR vaccine was recommended. By 2000, measles had been declared eliminated in the United States by the World Health Organization. Unfortunately, as the number of people who have received the measles immunization has decreased, infections have increased. In 2025, there were 2,255 reported cases of measles in the United States, the most measles infections reported since 1991. This steep escalation is concerning and the United States is at serious risk of losing its measles elimination status.

Measles Transmission, Symptoms, and Spread

The most common symptoms of measles infection are fever, cough, coryza (runny nose), and conjunctivitis (red/watery eyes)—often termed the ‘three C’s.’ These symptoms are followed by a red, blotchy rash that occurs around 3-5 days later, starting at the hairline and spreading downwards. Persons infected with the measles can transmit the virus from around four days before the rash appears to around four days after. Thus, many people transmitting the measles virus don’t yet realize they have it.

The measles virus is widely considered the most infectious pathogen in the world. It is commonly spread through coughing or sneezing and can stay active in the air or on surfaces for up to two hours. On average, one person with measles can infect 12 to 18 other susceptible people. By comparison, a person with COVID-19 infection or the flu infects only one or two other people, on average.

Recent Measles Outbreak

There is currently a very large outbreak of measles in South Carolina, centered in Spartanburg. Since October 2025, there have been more than 800 cases of measles in South Carolina to date, most in Spartanburg County. Unfortunately, this outbreak has spread into western North Carolina, and we now have 15 documented cases of measles in North Carolina. Given how easily measles spread, there are undoubtedly more undiagnosed cases of measles in North Carolina. Additionally, we’ve seen how Los Angeles public health officials are tracing a traveler’s journey and potential exposure at heavily trafficked sites, including Los Angeles Airport and Disneyland.

What does this mean for Durham County? Communities are best protected against measles if vaccination rates exceed 95%, and we have pockets within Durham County that are under-vaccinated, including in some of our schools. A single measles case in a school is a major public health concern. Just one contagious student attending school can result in over a dozen infections and dozens or even hundreds of students needing to quarantine for 21 days if they are unvaccinated or not immune. This could mean numerous potentially missed school days for our children.

Protecting Yourself and Others

Fortunately, we have a great tool at our disposal to prevent measles, and it is incredibly safe. The MMR vaccine is one of the safest and most effective vaccines that we have. One dose of the MMR vaccine is around 93% effective, and two doses are around 97% effective in preventing measles. This immune protection is lifelong. Check your immunization records or check with your doctor to see if you are immune. If you are not immune to measles, I would strongly advise you consider getting the MMR vaccine. If your kids are not immune to the measles, please get them vaccinated.

The MMR vaccine protects you against the measles virus and it also protects others in the community who either cannot get the MMR vaccine, such as children under the age of six months, or others who may have received vaccination against measles but whose immune system may not be working well enough to adequately protect them, such as individuals with cancer, those on immunosuppression, or who are elderly.

We are prepared for possible measles cases in Durham County. We are counting on all Durhamites to do their part to help us prevent measles outbreaks in our community and in our schools. If you or your child is not currently immune to measles, please get vaccinated now. Do your part to help protect yourself and protect the broader community from this incredibly infectious virus.

I would like to give special thanks to Dr. Jeff Jenks, Medical Director for the Durham County Department of Public Health, for his consultation and superb thoughts on this topic.

Sincerely,

Rodney E. Jenkins, Sr., DrPH, MHA

Public Health Director

Durham County Department of Public Health