Measles has seen a resurgence in the United States in 2025, with significant outbreaks reported, particularly in Texas and New Mexico. As of June 3, 2025, the Johns Hopkins Bloomberg School of Public Health’s U.S. Measles Tracker reported there were 1,151 confirmed cases of measles in the United States. Most cases are among unvaccinated children and adolescents, and there have been multiple deaths associated with the outbreaks. The majority of outbreaks have occurred in close-knit communities with low vaccination coverage, and frequent travel among these communities has facilitated the spread of the virus. Despite these outbreaks, the overall risk for widespread measles transmission in the United States remains low due to generally high immunization rates and robust public health response systems.

Quick Hits

• The CDC recommends that employers immediately notify health authorities if an employee is exposed to measles.
• The CDC also recommends employers exclude exposed employees without immunity from the workplace from day five to day twenty-one after exposure.
• Employers may want to support exposed employees with leave options and ensure thorough cleaning of affected areas.

Measles is highly contagious, transmitted via airborne droplets, and can remain infectious in the air and on surfaces for up to two hours after an infected person leaves an area. Infected individuals are contagious from four days before to four days after the onset of rash. Complications can be severe, including pneumonia, encephalitis, and death, especially in young children and immunocompromised individuals.

CDC Guidance Related to Measles in the General Population

The Centers for Disease Control and Prevention (CDC) recently reported that it received sixty-two reports of people with measles traveling on airplanes since the beginning of the year. It investigated fifty cases of travelers flying into the United States or domestically and found “only one situation” in which measles appeared to have been transmitted during air travel. While droplet precautions, much as was the case with COVID-19, can prevent the spread and transmission of measles, it does not appear that there is significant concern with air travel.

The CDC offers a number of recommendations related to measles in the general population, including:

• Vaccination: The CDC emphasizes that the measles-mumps-rubella (MMR) vaccine is the most effective tool for preventing measles and its complications. All U.S. residents, especially those planning international travel, should be up to date on their MMR vaccinations. Two doses of MMR vaccine provide about 97 percent protection.
• Clinical Vigilance: Healthcare providers should be alert for febrile rash illnesses that could be measles, especially in unvaccinated individuals or those with recent travel to outbreak areas.
• Isolation and Infection Control: Suspected measles cases should be immediately isolated, ideally in an airborne infection isolation room (AIIR). Healthcare personnel should use appropriate respiratory protection (e.g., N95 respirators) when caring for suspected or confirmed measles patients.
• Reporting: Measles is a nationally notifiable disease. Suspected or confirmed cases must be reported to local and state health departments within twenty-four hours.
• Post-Exposure Prophylaxis: For individuals exposed to measles who lack evidence of immunity, post-exposure prophylaxis with MMR vaccine (within seventy-two hours) or immunoglobulin (within six days) should be considered.
• Supportive Care: There is no specific antiviral treatment for measles; care is supportive, addressing symptoms and complications.

Handling Measles in the Workplace

Employers contemplating how to handle measles in the workplace or exposures of employees to measles, might consider taking the following actions:

Coordination With Health Authorities

As soon as an employer learns that an employee without evidence of immunity (i.e., no documentation of two doses of MMR vaccine, no laboratory evidence of immunity, no history of measles, or not born before 1957) has been exposed to measles, that employer may want to notify its local or state public health department. Public health professionals will provide guidance on next steps, help assess the risk and may initiate contact tracing and broader community protection measures.

Exposed Employees and the Workplace

Exposed employees without presumptive evidence of immunity would likely need to be excluded from the workplace from the fifth day after their first exposure through the twenty-first day after their last exposure, regardless of whether they receive post-exposure prophylaxis. This is to prevent potential transmission during the incubation period, as measles is highly contagious even before symptoms appear.

Post-Exposure Prophylaxis

MMR Vaccine: If the exposure was within the last seventy-two hours, the MMR vaccine can function as post-exposure prophylaxis. This can help prevent or lessen the severity of illness if administered promptly. Exposed employees can consult with their physicians or licensed healthcare providers to determine whether this approach is appropriate.

Immune Globulin: If more than seventy-two hours but fewer than six days have passed since exposure, immune globulin may be administered to reduce the risk or severity of disease, especially for high-risk individuals (e.g., pregnant women, immunocompromised persons, infants). Again, the employees can consult with their physicians or other licensed healthcare providers to determine if this is the right treatment.

Healthcare Workers: Exposed healthcare personnel without evidence of immunity should not return to work even if they receive the MMR vaccine. They should be excluded from work from day five after the first exposure through day twenty-one after the last exposure.

Monitor for Symptoms

The exposed employee will want to monitor for symptoms of measles (fever, cough, runny nose, red/watery eyes, rash) for at least twenty-one days after the last exposure. If symptoms develop, they can contact their healthcare providers before visiting any medical facility to prevent further spread.

Confidentiality and Communication

Employers may want to carefully determine to whom they can disclose the identity of exposed employees. The Americans with Disabilities Act and other laws determine whether employers must keep medical information confidential.

Employers with an exposed employee may notify other employees that a potential exposure has occurred (without identifying the individual) and provide information about measles symptoms, transmission, and the importance of vaccination. Employers can also encourage all employees to verify their immunization status and seek vaccination if needed.

Workplace Precautions and Support

Employees can consider offering leave options, such as leave under their paid sick leave policies or as available under the Family and Medical Leave Act (FMLA), as applicable.

Employers may need to ensure thorough cleaning and disinfection of areas where the exposed employee worked, as the measles virus can remain infectious in the air and on surfaces for up to two hours.

Review and Update Policies

Employers may want to ensure that workplace policies are up to date regarding infectious disease exposures, reporting, and return-to-work criteria. Additionally, employers might use an incident as an opportunity to educate and prepare the workforce.

Recordkeeping

While 29 CFR 1904.5(b)(2)(viii) exempts recording of the common cold and flu, measles is a recordable illness when a worker is infected on the job.

By following these steps, employers can help prevent the spread of measles in the workplace, protect vulnerable employees, and comply with public health and legal requirements.