top of page

City-County Health District

Measles

Status: Current North Dakota measles case counts are available at NDHHS Measles, as is information on possible exposure locations. North Dakotans who are vaccinated against measles are well protected and at low risk. 
 

Updated May 21, 2025

Report Suspected Measles Cases IMMEDIATELY! 

Call the HHS Immunization Unit at 701.328.2378 and fax report to City-County Health District at 701.845.8542.

What is Measles? 

Measles is a highly contagious virus that spreads through the air when an infected person coughs or sneezes. Symptoms typically appear 7-14 days after exposure and can include:
 

  • High fever

  • Cough

  • Runny nose

  • Red, watery eyes

  • A rash that starts on the face and spreads to the rest of the body

 

One out of every five children who get measles in the United States will be hospitalized. One or two out of every 1,000 children in the United States who get measles will die from the disease, even with the best care.
 
Measles can cause serious health problems, such as:
 

  • Pneumonia, an infection of the lungs.

  • Brain damage caused by swelling.

  • Deafness.

A vaccine can prevent measles

You can protect yourself and the people around you from measles. The best protection against measles is a measles, mumps, and rubella (MMR or MMRV) vaccine.

​

Two doses of the measles vaccine are about 98% effective at preventing measles. Anyone unsure of their vaccination status should contact City-County Health District or their healthcare provider.

Resources for schools, childcare, employers

Frequently Asked Questions

  • One out of every five children who get measles in the United States will be hospitalized. One or two out of every 1,000 children in the United States who get measles will die from the disease, even with the best care.
     
    Measles can cause serious health problems, such as:

    • Pneumonia, an infection of the lungs.

    • Brain damage caused by swelling.

    • Deafness.

  • You are considered immunized against measles if you have written documentation (records) showing at least one of the following:

    • You received two doses of measles-containing vaccine, and you are a(n) —

      • school-aged child (grades K-12)

      • adult who will be in a setting that poses a high risk for measles transmission, including students at post-high school education institutions, health care personnel, and international travelers.

    • You received one dose of measles-containing vaccine, and you are a(n) —

      • preschool-aged child (12 months to 4 years)

      • adult (born in 1957 or later) who will not be in a high-risk setting for measles transmission.

    • Laboratory confirmed that you had measles at some point in your life.

    • Laboratory confirmed that you are immune to measles.

    • You were born before 1957.

    • Infants who are too young for routine vaccination and people with medical conditions where they can't receive a measles vaccine depend on high MMR vaccination coverage among those around them. 
       

    • In the event of a local outbreak or international travel, infants as young as 6 months can be given a dose of MMR vaccine in addition to the regular MMR 2-dose series.

  • If you have been exposed to measles, you need to quarantine (stay home):

    • If you have NOT had any doses of measles vaccine.

    • ​If you are NOT immune to measles through prior infection

    ​

    You do NOT need to quarantine (stay at home):

    • If you have had one or more doses of measles vaccine.

    • If you are immune to measles from prior infection.

    • If you were born before 1957.

    • If you have received a measles vaccine within 72 hours of your first exposure.

    ​

    Questions? Don't be afraid to ask your healthcare provider or call City-County Health District at 845.8518.

  • North Dakota residents can get their immunization record by

    ​

    If you were born outside of North Dakota and need to locate your immunization records, here are a few helpful tips:

    • Contact the local public health unit where you resided

    • Contact your previous clinic or healthcare provider

    ​

    If you need additional help locating records, please give us a call.

    ​

    ​Once you locate your records, you can bring a copy to City-County Health District and we will create a North Dakota immunization record for you.

  • North Dakota and many other states are at risk of measles outbreaks due to declining measles immunization rates and increases in measles cases worldwide. Measles, Mumps, and Rubella (MMR) vaccination rates in young children ages 19-35 months are about 81%, and kindergarten MMR vaccination rates are about 90%. Rates are below 95% threshold needed for community protection (herd immunity).

  • Measles can lead to serious complications and death, even with modern medical care. The 1989–1991 measles outbreak in the U.S. resulted in more than 55,000 cases and more than 100 deaths. In the United States, from 1987 to 2000, the most commonly reported complications associated with measles infection were pneumonia (6%), otitis media (7%), and diarrhea (8%). For every 1,000 reported measles cases in the United States, approximately one case of encephalitis and two to three deaths resulted. The risk for death from measles or its complications is greater for infants, young children, and adults than for older children and adolescents.

    ​

    Mumps most commonly causes fever and parotitis. Up to 25% of persons with mumps have few or no symptoms. Complications of mumps include orchitis (inflammation of the testicle) and oophoritis (inflammation of the ovary). Other complications of mumps include pancreatitis, deafness, aseptic meningitis, and encephalitis. Mumps illness is typically milder, with fewer complications, in fully vaccinated case patients.

    ​

    Rubella is generally a mild illness with low-grade fever, lymphadenopathy, and malaise. Up to 50% of rubella virus infections are subclinical. Complications can include thrombocytopenic purpura and encephalitis. Rubella virus is teratogenic and infection in a pregnant woman, especially during the first trimester can result in miscarriage, stillbirth, and birth defects including cataracts, hearing loss, mental retardation, and congenital heart defects.

  • Healthcare providers should suspect measles in patients with a febrile rash illness and the clinically compatible symptoms of cough, coryza (runny nose), and/or conjunctivitis (red, watery eyes). The illness begins with a prodrome of fever and malaise before rash onset. A clinical case of measles is defined as an illness characterized by

    ​

    • a generalized rash lasting 3 or more days, and

    • a temperature of 101°F or higher (38.3°C or higher), and

    • cough, coryza, and/or conjunctivitis.
       

    Koplik spots, a rash present on mucous membranes, are considered pathognomonic for measles. Koplik spots occur from 1 to 2 days before the measles rash appears to 1 to 2 days afterward. They appear as punctate blue-white spots on the bright red background of the buccal mucosa. Pictures of measles rash and Koplik spots can be found at www.immunize.org/clinical/image-library/measles/.

    ​

    Providers should be especially aware of the possibility of measles in people with fever and rash who have recently traveled abroad or to an area with an ongoing outbreak in the United States, or those who have had contact with people from an outbreak area or international travelers. Providers should immediately isolate and report suspected measles cases to their local health department and obtain a nasopharyngeal, throat, and/or urine specimen for diagnosis confirmation and virus genotyping. Providers should also collect blood for serologic testing during the first clinical encounter with a person who has suspected or probable measles.

  • For measles, there is an average of 10 to 12 days from exposure to the appearance of the first symptom, which is usually fever. The measles rash doesn’t usually appear until approximately 14 days after exposure (range: 7 to 21 days), and the rash typically begins 2 to 4 days after the fever begins. The incubation period of mumps averages 16 to 18 days (range: 12 to 25 days) from exposure to onset of parotitis. The incubation period of rubella is 14 days (range: 12 to 23 days). However, up to half of rubella virus infections cause no symptoms.

  • MMR can be given to children as young as 6 months of age who are at high risk of exposure such as during international travel or a community outbreak. However, doses given BEFORE 12 months of age cannot be counted toward the 2-dose series for MMR.

  • Measles vaccine, given as MMR, may be effective if given within the first 3 days (72 hours) after exposure to measles. Immune globulin may be effective for as long as 6 days after exposure. Postexposure prophylaxis with MMR vaccine does not prevent or alter the clinical severity of mumps or rubella. However, if the exposed person does not have evidence of mumps or rubella immunity they should be vaccinated since not all exposures result in infection.

    ​

    Rubella was declared eliminated (the absence of endemic transmission for 12 months or more) from the United States in 2004. Fewer than 10 cases (primarily import-related) have been reported annually in the United States since elimination was declared. Rubella incidence in the United States has decreased by more than 99% from the pre-vaccine era. A provisional total of 3 cases of rubella, and no cases of congenital rubella syndrome, were reported in 2022.

  • You are correct that vaccinated people can still be infected with viruses or bacteria against which they are vaccinated. No vaccine is 100% effective. Vaccine effectiveness varies from greater than 95% (for diseases such as measles, rubella, and hepatitis B) to much lower (60% for influenza in years with a good match of circulating and vaccine viruses, and 70% for acellular pertussis vaccines in the 3-5 years after vaccination). More information is available for each vaccine and disease at www.cdc.gov/vaccines/by-disease/ and www.immunize.org/vaccines.

bottom of page