What to know about measles

Measles is more than just a rash. While vaccinated Delmarva residents don’t have much to worry about, the disease is a concern for those who are unvaccinated, experts say.  

The Delaware Division of Public Health reported an outbreak Wednesday, July 22. At that time, there were four unvaccinated men from Kent County with the disease, and the illness can easily spread. Just two days before, the agency reported that the first case was the first confirmed measles case in Delaware in more than a decade. 

The outbreak is concerning to Ghazaleh Barghgir, MD, who cares for patients at TidalHealth Primary Care in Seaford.  

“Four cases may sound like a small number, but measles is one of the most contagious infections we encounter,” Dr. Barghgir said. “A single infected person can expose many others, particularly in settings where people are unvaccinated or where infants and immunocompromised individuals are present.” 

Maryland has seen 12 cases so far in 2026, according to the Maryland Department of Health Center for Immunization. Across the country, the U.S. Centers for Disease Control has tracked 2,318 measles cases in 2026 as of July 24, while in 2025, there were 2,288 tracked cases during the entire year. The 2026 number is the highest number of confirmed cases since 1991, with more than five months left in the year. 

People who have received two appropriately timed doses of the MMR (measles, mumps and rubella) vaccine are about 97% protected, Dr. Barghgir said. One dose of the vaccine is about 93% effective against the disease, she said.  

“People who are unvaccinated or do not have evidence of immunity are at substantially greater risk of becoming infected and developing complications,” Dr. Barghgir said. 

If someone isn’t vaccinated but wants to be, there is still time. It usually takes about two weeks for the vaccine to be effective, Dr. Barghgir said, but if someone gets the MMR vaccine within 72 hours of exposure, it may prevent the illness or make it less severe. Immune globulin may be recommended for some high-risk people after exposure. 

Anyone who thinks they've been exposed should contact a healthcare practitioner or a public health agency, such as the Delaware Division of Public Health, if in Delaware, said Dr. Barghgir.  

Most adults born in 1957 or later, or without other evidence of immunity, need one dose, though practitioners may recommend two in some cases, Dr. Barghgir said.  

The MMR vaccine is not given to people who are pregnant or severely immunocompromised, so people who fall into those categories should contact their healthcare practitioner regarding protection or if exposed, she said.  

Babies younger than six months are also unable to receive the MMR vaccination. Normally, the first dose is given when the child is 12 to 15 months old, but if there is an outbreak, public health officials may recommend an early dose for infants ages 6 to 11 months, Dr. Barghgir said. Infants who received an early dose would still need to receive the two regularly recommended doses. 

If the mother is immune, the infant may receive some antibodies, but it gradually declines and should not be considered complete protection, she said.  

Symptoms 

The rash normally develops several days later, beginning on the face and spreading downward.  

It’s possible for people to spread measles before they realize they have it, through breathing, talking, coughing or sneezing — and the virus can remain infectious for up to two hours. 

“People are generally contagious from four days before the rash develops until four days afterward,” Dr. Barghgir said. “Because it spreads so efficiently, people who suspect measles should not enter a medical office, urgent-care center or emergency department without calling ahead. Calling first allows the facility to take precautions and avoid exposing other patients.” 

“Approximately one in five unvaccinated people in the United States who develops measles is hospitalized,” Dr. Barghgir said. “Measles can also cause pregnancy complications and, rarely, death. A very rare but fatal neurologic condition called subacute sclerosing panencephalitis can develop years after the original infection.” 

In 2025, 11 percent of people who contracted measles were hospitalized, while so far in 2026, that number is 7 percent, according to the CDC.  

“The most important step is to verify vaccination status now, rather than waiting until an exposure occurs,” Dr. Barghgir said. “People should also recognize the early symptoms and watch for official exposure announcements.”