Hawaii is once again confronting the threat of the measles virus, highlighting the state’s vulnerability to this highly contagious disease. As the number of measles cases continues to rise across the U.S. Mainland, the risk of exposure in the islands increases, especially given that Hawaii is a significant travel hub frequented by visitors from various regions. State Epidemiologist Dr. Sarah Kemble emphasized the importance of vigilance, stating, “We are a major international travel hub and a major destination from the U.S. Mainland too. So it is important to remember that measles is just a plane ride away. It may arrive knocking at our door at any point in time.”
This alert came to light earlier this month when the Hawaii Department of Health (DOH) announced that a visitor to Oahu had been diagnosed with measles. The individual, a vaccinated adult, had recently traveled from a region in the continental U.S. With known measles transmission. After seeking medical care, the visitor has since recovered and is no longer infectious, according to the DOH.
In response to this diagnosis, the DOH has released a list of locations where individuals may have been exposed to the virus, including the Daniel K. Inouye International Airport, the Laie Mormon Temple, Hilo International Airport, a Thai restaurant in Hilo, and Hawai‘i Volcanoes National Park. The DOH advises that the first symptoms of measles typically appear seven to 14 days after exposure, but can take as long as 21 days. Initial symptoms include high fever, cough, runny nose, and red, watery eyes, followed by a rash characterized by red spots that spread from the face downwards.
Understanding Breakthrough Cases
While breakthrough cases in vaccinated individuals are uncommon, they can occur. Dr. Kemble noted that various factors, such as the individual’s immune response or prior viral infections, can contribute to these cases. Fortunately, the recent case was mild, and no severe illness was reported. “We treat all measles cases as measles cases,” she added, highlighting the DOH’s proactive approach in handling potential outbreaks.
Current Measles Situation in the U.S.
The number of confirmed measles cases in the U.S. Has surged significantly. As of March 12, 2026, the Centers for Disease Control and Prevention (CDC) reported 1,362 confirmed measles cases this year alone, with outbreaks reported in 31 jurisdictions, including states such as Alaska, California, Texas, and South Carolina. South Carolina has reported the highest number of cases, with 993 cases linked to an outbreak that began in October 2025, primarily affecting unvaccinated children.
In 2025, Hawaii was among the 45 states that reported measles cases, with nearly 50 outbreaks noted, resulting in three deaths associated with the disease. The DOH previously confirmed a measles case in April 2025 involving a child under 5 years old returning from international travel. Fortunately, strict follow-up measures ensured that no further cases emerged from that situation.
Monitoring and Prevention Efforts
Last year, the measles virus was also detected in wastewater samples across various regions in Hawaii, serving as an early warning system for potential virus presence. However, no confirmed human cases followed these detections. The last reported measles case in Hawaii prior to the recent diagnosis occurred in April 2023, involving an unvaccinated resident returning from abroad.
Measles is known for its high contagion rate; according to the CDC, up to 90% of people who are not immune can become infected if exposed to the virus. It can spread through direct contact or via respiratory droplets in the air after an infected person coughs or sneezes. The virus can remain airborne for up to two hours after the infected person has left the area.
Vaccination Rates Declining
Health experts stress that vaccination is the most effective way to prevent measles. The recommended vaccination schedule includes two doses of the measles, mumps, and rubella (MMR) vaccine, typically given at 12 to 15 months and again at 4 to 6 years of age, which is approximately 97% effective. However, Hawaii has seen a decline in vaccination rates over the past decade. The current rate for kindergartners in Hawaii is about 89.9%, below the national average and the target threshold of 95% necessary for herd immunity.
This decline in vaccination rates is concerning, particularly as Hawaii has historically maintained a rate of 95%. The decline began prior to the COVID-19 pandemic and has been exacerbated by vaccine hesitancy fueled by misinformation. With the U.S. Poised to lose its measles elimination status—held since 2000—there is a pressing necessitate for increased awareness and action regarding vaccinations.
What to Do If Exposed
If individuals were present at any of the specified locations during the relevant times, they should monitor for symptoms until three weeks post-exposure and consult a healthcare provider if symptoms arise. The DOH notes that the MMR vaccine can prevent or mitigate the severity of measles if administered within 72 hours of exposure.
As health officials remain vigilant, they encourage the public to check immunization records, especially for those traveling out of state. It may be advisable to consult a healthcare provider about receiving an additional or earlier dose of the MMR vaccine, particularly for children.
For further inquiries or reporting potential measles cases, the Hawaii Department of Health can be contacted at 808-586-4586. Staying informed and proactive is crucial in combating this contagious disease.
This content is for informational purposes only and is not intended as professional medical advice.
