North Dakota is 11th US state with a measles outbreak. Here's what to
know
[May 07, 2025]
By DEVI SHASTRI
North Dakota is the 11th state in the U.S. with a measles outbreak,
logging its first cases since 2011.
The U.S. Centers for Disease Control and Prevention's confirmed measles
case count is 935, more than triple the amount seen in all of 2024. The
three-month outbreak in Texas accounts for the vast majority of cases,
with 702 confirmed as of Tuesday. The outbreak has also spread to New
Mexico, Oklahoma and Kansas.
Two unvaccinated elementary school-aged children died from
measles-related illnesses in the epicenter in West Texas, and an adult
in New Mexico who was not vaccinated died of a measles-related illness.
Other states with active outbreaks — which the CDC defines as three or
more related cases — include Indiana, Michigan, Montana, Ohio,
Pennsylvania and Tennessee.
North America has two other ongoing outbreaks. One in Ontario, Canada,
has resulted in 1,243 cases from mid-October through April 29. And the
Mexican state of Chihuahua had 922 measles cases and one death as of
Tuesday, according to data from the state health ministry. Health
officials in Mexico and the U.S. say all three outbreaks are of the same
measles strain.
Measles is caused by a highly contagious virus that’s airborne and
spreads easily when an infected person breathes, sneezes or coughs. It
is preventable through vaccines, and has been considered eliminated from
the U.S. since 2000.
As the virus takes hold in U.S. communities with low vaccination rates,
health experts fear that spread could stretch on for a year. Here's what
else you need to know about measles in the U.S.
How many measles cases are there in Texas and New Mexico?
Texas state health officials said Tuesday there were 19 new cases of
measles since Friday, bringing the total to 702 across 29 counties —
most of them in West Texas. The state also added two hospitalizations to
its count Friday, for a total of 91 throughout the outbreak.
State health officials estimated about 1% of cases — fewer than 10 — are
actively infectious.
Fifty-seven percent of Texas' cases are in Gaines County, population
22,892, where the virus started spreading in a close-knit,
undervaccinated Mennonite community. The county has had 403 cases since
late January — just over 1.7% of the county's residents.
The April 3 death in Texas was an 8-year-old child, according to Health
Secretary Robert F. Kennedy Jr. Local health officials in Texas said the
child did not have underlying health conditions and died of “what the
child's doctor described as measles pulmonary failure.” A unvaccinated
child with no underlying conditions died of measles in Texas in late
February — Kennedy said age 6.
New Mexico was steady Tuesday with 67 total cases. Seven people have
been hospitalized since the outbreak started. Most of the state's cases
are in Lea County. Three are in Eddy County, two in Doña Ana County and
one in Chaves County.
How many cases are there in Indiana?
Indiana confirmed two more cases April 21 in an outbreak that has
sickened eight in Allen County in the northeast part of the state — five
are unvaccinated minors and three are adults whose vaccination status is
unknown.
The cases have no known link to other outbreaks, the Allen County
Department of Health has said.
How many cases are there in Kansas?
Kansas added nine cases Wednesday for a total of 46 across eight
counties in the southwest part of the state. Gray County is up to 15
cases. The state also reported its first hospitalization.
Kansas' health department didn't elaborate Wednesday about a discrepancy
in the number of new cases at the state and county levels beyond noting
that case counts are “fluid as the outbreak progresses."
The state's first reported case is linked to the Texas outbreak based on
genetic testing.
How many cases are there in Michigan?
Montcalm County, near Grand Rapids in western Michigan, has an outbreak
of four cases that state health officials say is tied to the Ontario
outbreak. The state had nine confirmed measles cases as of Friday, but
the remaining five are not part of the Montcalm County outbreak.
How many cases are there in Montana?
Montana state health officials announced five cases April 17 in
unvaccinated children and adults who had traveled out of state, and
later confirmed it was an outbreak. All five are isolating at home in
Gallatin County in the southwest part of the state.
They were Montana’s first measles cases in 35 years. Health officials
didn’t say whether the cases are linked to other outbreaks in North
America.
How many measles cases are there in North Dakota?
North Dakota announced its first measles case since 2011 on Friday, and
by Tuesday, there were nine cases.
All are in Williams County in western North Dakota on the Montana
border. The state health department said Monday that three of the
confirmed cases are linked to the first case — an unvaccinated child who
health officials believe got it from an out-of-state visitor.
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 The other five cases, announced
Tuesday, were people who were not vaccinated and did not have
contact with the other cases, causing concern about community
transmission. The state health department said four people diagnosed
with measles attended classes while infectious at a Williston
elementary school, middle school and high school.
How many cases are there in Ohio?
The state has two outbreaks. Ashtabula County near Cleveland has 16
cases. And Knox County in east-central Ohio has 20 — 14 among Ohio
residents and the rest among visitors.
The Ohio Department of Health on Thursday confirmed 33 measles cases
and one hospitalization. That count includes only Ohio residents.
Defiance County in the northwestern part of the state has logged its
first case.
Allen and Holmes counties have had one case each.
How many cases are there in Oklahoma?
Oklahoma added one case for a total of 14 confirmed and three
probable cases as of Tuesday. The outbreak is linked to Texas and
New Mexico.
The state health department is not releasing which counties have
cases, but Cleveland, Oklahoma and Sequoyah counties have had public
exposures in the past couple of months.
How many cases are there in Pennsylvania?
There are eight measles cases in Erie County in far northwest
Pennsylvania, officials said Friday. The county declared an outbreak
in mid-April. The state has said it has 13 cases overall in 2025,
including international travel-related cases in Montgomery County
and one in Philadelphia.
How many cases are there in Tennessee?
Tennessee had six measles cases as of last week. Health department
spokesman Bill Christian said all cases are the middle part of the
state, and that “at least three of these cases are linked to each
other” but declined to specify further. The state also did not say
whether the cases were linked to other outbreaks or when Tennessee's
outbreak started.
The state health department announced the first measles case March
21, three more on April 1 and the last two on April 17, but none of
the news releases declared an outbreak. However, Tennessee was on a
list of outbreak states in a CDC report April 17.
Where else is measles showing up in the U.S.?
Cases also have been reported in Alaska, Arkansas, California,
Colorado, Florida, Georgia, Hawaii, Illinois, Kentucky, Louisiana,
Maryland, Minnesota, Missouri, New Jersey, New York, Rhode Island,
Vermont, Virginia and Washington.
Cases and outbreaks in the U.S. are frequently traced to someone who
caught the disease abroad. In 2019, the U.S. saw 1,274 cases and
almost lost its status of having eliminated measles.
What do you need to know about the MMR vaccine?
The best way to avoid measles is to get the measles, mumps and
rubella vaccine. The first shot is recommended for children between
12 and 15 months old and the second between 4 and 6 years old.
Getting another MMR shot is harmless if there are concerns about
waning immunity, the CDC says. People who have documentation of
receiving a live measles vaccine in the 1960s don’t need to be
revaccinated, but people who were immunized before 1968 with an
ineffective measles vaccine made from “killed” virus should be
revaccinated with at least one dose, the agency said.
People who have documentation that they had measles are immune and
those born before 1957 generally don’t need the shots because most
children back then had measles and now have “presumptive immunity.”
In communities with high vaccination rates — above 95% — diseases
like measles have a harder time spreading through communities. This
is called “herd immunity.”
But childhood vaccination rates have declined nationwide since the
pandemic and more parents are claiming religious or personal
conscience waivers to exempt their kids from required shots. The
U.S. saw a rise in measles cases in 2024, including an outbreak in
Chicago that sickened more than 60.
What are the symptoms of measles?
Measles first infects the respiratory tract, then spreads throughout
the body, causing a high fever, runny nose, cough, red, watery eyes
and a rash.
The rash generally appears three to five days after the first
symptoms, beginning as flat red spots on the face and then spreading
downward to the neck, trunk, arms, legs and feet. When the rash
appears, the fever may spike over 104 degrees Fahrenheit, according
to the CDC.
Most kids will recover from measles, but infection can lead to
dangerous complications such as pneumonia, blindness, brain swelling
and death.
How can you treat measles?
There’s no specific treatment for measles, so doctors generally try
to alleviate symptoms, prevent complications and keep patients
comfortable.
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AP Science Writer Laura Ungar contributed to this report.
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