Measles Tops 4,000 Cases as Pennsylvania Outbreak Puts Nurses on the Front Lines

Image source: CDC

The United States has now confirmed 4,080 measles cases in 2026, the highest annual total since 1991, according to the latest Centers for Disease Control and Prevention (CDC) data. Pennsylvania alone accounts for more than a quarter of them, according to the state’s Department of Health.

The CDC added 194 new cases in the past week, and infections have now been confirmed in 45 states and Washington, D.C. This year’s count is already far beyond 2025’s total of 2,289 cases, which was itself a three-decade high at the time.

For nurses in emergency departments, pediatric units, labor and delivery, and public health, this is no longer a distant headline. It is a daily infection-control reality, and in at least one state, it is already expanding what nurses are legally allowed to do.

Want to see more Nurse.org articles in your Google results? Add us as a preferred source.

Pennsylvania has reported 1,136 confirmed cases, including 157 in the past seven days alone. Lancaster County has been hit hardest with 415 cases, followed by Mifflin County with 167, CIDRAP reports.

The Pennsylvania numbers stand out in several troubling ways. According to CIDRAP:

• 99% of Pennsylvania patients were unvaccinated
• 19% have been hospitalized, nearly double the national rate of 10%
• 67% of cases are in adults, which runs counter to national trends where children and teens make up most infections

The state has reported five measles-associated deaths this year, two infants and three adults, while the CDC currently recognizes two deaths nationally. Pennsylvania defines a measles-associated death as one occurring within 30 days of symptom onset with clinical and lab evidence, excluding unrelated causes.

Because measles typically kills about 1 to 3 of every 1,000 people infected, experts cited by CIDRAP say five deaths suggest the true size of the outbreak is likely larger than the confirmed count.

The outbreak is also spreading beyond its original communities. A child at a private Christian school in Allegheny County recently tested positive; that school’s vaccination rate is 81%, well below the 92% to 95% needed for herd immunity.

According to the Pennsylvania Department of Health, records indicate that more than 56,000 MMR doses were administered in September, more than double the roughly 25,000 doses it gives in a typical month.

On Sept. 11, a visitor later confirmed to have measles spent time in the Neonatal Intensive Care Unit (NICU) at Children’s Hospital of Philadelphia (CHOP), potentially exposing infants, families, and staff, according to The Philadelphia Inquirer. CHOP said it identified babies who may have been exposed, offered them preventive treatment, and isolated exposed patients while doctors monitored them for symptoms.

According to NBC10, Philadelphia health officials said the possible exposure happened at CHOP’s main building at 3401 Civic Center Boulevard at these times and locations:

• Between 9:30 a.m. and 4:15 p.m. at NICU West
• Between 9:30 a.m. and 4:15 p.m. at NICU West Family Lounge
• Between 9:30 a.m. and 4:15 p.m. at the CHOP Atrium
• Between 12:05 p.m. and 2:45 p.m. at the CHOP Main Cafeteria

City health officials said they were working with CHOP and the state to give potentially exposed infants a “preventative antibody product” to prevent measles or lessen its severity. Anyone exposed who wasn’t immune was told to mask in indoor public spaces for three weeks afterward, a window that closed in early October.

“Given the ongoing outbreaks in Pennsylvania and other places, it is imperative that everyone who is not up to date on their MMR vaccine gets their vaccine as soon as possible. Remember, this is not just about protecting yourself, it’s about protecting our most vulnerable Philadelphians,” Health Commissioner Dr. Palak Raval-Nelson said.

>>Listen to The Latest Nurse News Podcast

Outbreaks Are Spreading, and New York Just Expanded Nurses’ Authority

Pennsylvania is far from alone. The CDC has tracked 42 outbreaks in 2026, and 96% of all cases are outbreak-associated. Only 18 cases have been linked to international travel. Other states with significant activity include Wisconsin (263 cases), Ohio (231), Kentucky (104), and New York (102), per CIDRAP.

On Oct. 5, New York Gov. Kathy Hochul declared a state disaster emergency. Her executive order allows paramedics, advanced EMS providers, pharmacists, and midwives to administer vaccines, and it gives nurses the ability to order measles testing, a step previously limited to physicians.

“No one should get seriously ill or die from a vaccine-preventable disease,” Hochul said.

At the federal level, the CDC has sent $100 million to states for outbreak response. CDC Director Erica Schwartz, MD, MPH, JD, urged parents to prioritize vaccination, saying the “MMR vaccine is absolutely safe, absolutely effective.”

Nationally, about 95% of cases have occurred in people who were unvaccinated or whose status is unknown. Kindergarten MMR coverage has slipped to 92.4% for the 2025-26 school year, down from 95.2% before the pandemic, ABC News reports.

Experts warn the country’s measles elimination status, declared in 2000, is in jeopardy. “I think there’s a very strong chance that we would lose our elimination status,” John Brownstein, an epidemiologist at Boston Children’s Hospital, told ABC News.

Measles is one of the most contagious diseases known, and health care settings are prime spots for exposure. Here is what this surge means for nurses right now:

• Know the early signs. Symptoms typically begin 1 to 2 weeks after exposure with high fever, cough, runny nose, and red, watery eyes. Tiny white spots inside the mouth may appear 2 to 3 days later, and the rash follows 3 to 5 days after initial symptoms. Patients are contagious from 4 days before to 4 days after the rash appears.
• Triage and isolate fast. Any febrile patient with rash and possible exposure should be masked and placed in an airborne infection isolation room as quickly as possible, and the CDC advises staff entering those rooms to wear an N95 or similarly effective respirator.
• Check your own immunity. Two doses of MMR are 97% effective. If you are unsure of your vaccination status or titers, talk with employee health before an exposure happens.
• Expect adult patients. With two-thirds of Pennsylvania cases in adults, measles is not just a pediatric concern. Adult ED, med-surg, and OB nurses should keep it on their radar.
• Watch your scope of practice. New York’s emergency order shows how quickly nursing authority can expand during an outbreak. Nurses in affected states should stay alert to new executive orders or guidance that may change testing and vaccination protocols.
• Lead with education. Nurses remain among the most trusted voices in health care. Clear, judgment-free conversations about MMR safety can make a real difference with hesitant families.

🤔 Are you seeing measles patients or exposures at your facility, and has your employer changed its screening or isolation protocols? Share your experience in the comments.