Health Alert: Measles Outbreak and Cases in Washington

February 11, 2026

Date: February 11, 2026

This is a Health Alert from the Washington State Department of Health (WA DOH) regarding recent measles cases & and a measles outbreak in Washington state.

Cases of measles are increasing across the United States and internationally. Multiple unrelated cases of measles associated with domestic travel have been reported in Washington this year, and at least 3 cases have led to further spread of measles within the state.

Public health partners across Washington should be prepared to investigate, report, and facilitate testing for suspected cases of measles, and to communicate with healthcare providers and the public about measles.

Current Situation

On January 8, 2026, Washington State Department of Health was notified of 3 out-of-state visitors to Washington who were later confirmed to have measles. Public health investigation revealed the travelers visited several locations in Snohomish and King Counties while infectious for measles. These exposures led to several cases of measles in Snohomish County. Snohomish County Health Department declared a measles outbreak on January 15.

Unrelated to the Snohomish County outbreak, independent and distinct travel-related measles exposures have resulted in measles cases in at least 3 other Washington Counties. All cases of measles identified in Washington so far in 2026 have occurred in people who are unvaccinated or have unknown vaccination status. Vaccination with a measles-containing vaccine (MMR or MMRV vaccine) remains the most effective way to prevent measles.

As of February 11, 2026, a total of 21 cases of measles have been identified in Washington State this year. For updated case counts and a map of public exposure locations, see Measles Cases in Washington State.

Actions Requested

PREPARE

All Local Health Jurisdictions in Washington should prepare for measles cases in their jurisdiction.

Review the Measles Reporting and Surveillance Guidelines (PDF).
Be familiar with sources of measles information in Washington, including the Measles Cases in Washington State webpage.
Ensure after-hours contact information is up-to-date for your jurisdiction, and review measles reporting, investigation, and testing guidelines with staff who take after-hours calls.

IDENTIFY

Local Health Jurisdictions and healthcare providers should suspect a case of measles in anyone who:

Presents with or reports symptoms of measles:
- RASH (maculopapular, confluent, starts on face and spreads down).
- Fever (≥ 100.4°F, overlapping the rash onset).
- Has at least one of the “Three Cs” preceding the rash: Cough, coryza (runny nose), or conjunctivitis (red eyes).
  AND
Has one or more of the following RISK factors for measles:
- Is unvaccinated (zero doses of a measles-containing vaccine).
- Has exposure to a known case of measles within the last 21 days.
- Travel within the last 21 days:
  - To area with known community transmission of measles.
  - International travel.

The Suspect Measles Provider Evaluation Worksheet (PDF) can help guide both health care providers in your jurisdiction as well as public health investigators to assess the likelihood of measles.

Remind healthcare providers that measles is highly contagious, and measles virus may remain in the air for up to two hours after a patient leaves the room.

Healthcare facilities should ensure that anyone with a febrile rash illness is rapidly isolated and does not remain in common areas such as waiting rooms.
Providers should follow standard and airborne precautions when evaluating a patient for measles. Healthcare providers should wear eye protection when collecting specimens, and during other patient care activities if the patient is coughing or sneezing.
When healthcare workers, other patients, or visitors are exposed to a case of measles, the Local Health Jurisdiction or WA DOH may request additional information for a public health investigation.

INVESTIGATE

All Local Health Jurisdictions in Washington should be prepared to investigate cases of measles.

WA DOH has updated our Measles Reporting and Surveillance Guidelines (PDF), which public health jurisdictions can use to guide investigation of suspected cases of measles.

WA DOH maintains a Measles Public Exposure Location Map which shows sites where members of the public may have come into contact with someone infectious for measles in the last 21 days.

NOTIFY

Measles is an immediately notifiable condition in Washington state.

Local Health Jurisdictions should ensure that healthcare providers in their jurisdiction understand how to report a suspected case of measles.
- Ensure that healthcare facilities have up-to-date LHJ contact information for notification, including after-hours contact information.
When a Local Health Jurisdiction is notified of a suspected case of measles, they should in turn immediately notify WA DOH:
- By phone: 206-418-5500 (24/7 number – Calls are routed to the DOH Duty Officer on evenings, weekends, and holidays.)
- Refer to Measles - Notifiable Condition webpage for more information.

TEST

Testing for measles is available at the WA DOH Public Health Laboratories (PHL). Testing may also be available commercially.

Measles testing at PHL requires prior approval from the LHJ and WA DOH Communicable Disease Epidemiology.
- After testing approval from the LHJ, specimen information should be submitted using the WA DOH Lab Web Portal.
The gold standard confirmatory test for acute measles infection is RT-PCR (reverse transcription-polymerase chain reaction, often shortened to “PCR”).
- Specimen collection guidance for PCR specimens, as well as additional specimen types, is in the Measles Reporting and Surveillance Guidelines (PDF).
Viral load for measles is highest at the time of rash onset. PCR testing for measles is most accurate when specimens are collected between 0-3 days after rash onset.
- Testing patients for measles BEFORE rash onset is generally discouraged, as a negative test does not rule out acute measles infection, AND testing will need to be repeated if the initial test is negative and subsequently a rash develops.
- In limited situations, DOH may accept specimens for measles testing at PHL from symptomatic patients with an atypical rash or no rash. For example, in a patient with severe immune-compromising condition and a known measles exposure. Local Health Jurisdictions should contact the WA DOH Vaccine Preventable Disease team to discuss testing in these situations.
For more information about specimen submission, approval process, and testing turnaround time for measles, please see the Public Health Lab MMR Specimen Testing Protocol (PDF).

MANAGE

Once confirmed, patients with measles should ISOLATE at home until symptoms resolve. Generally, this is a minimum of 4 days after rash onset.
Close contacts should be notified of potential exposure to a confirmed case of measles.
- Close contacts who do not have evidence of immunity to measles may need to quarantine and/or may be excluded from specific work and school situations.
- Close contacts who are not immune to measles may be offered measles post-exposure prophylaxis (PEP).
- See the Measles Post Exposure Prophylaxis for Non-Symptomatic Susceptible Contacts (PDF) guide for more information about measles PEP.
Local Health Jurisdictions should advise all close contacts of cases who become symptomatic for measles to call ahead before seeking care at a healthcare facility in order to prevent further exposures.
If case investigations uncover that a case visited schools, childcare, healthcare, or other public settings during their infectious period, report these as soon as possible to WA DOH Communicable Disease Epidemiology.
- These locations will be updated on the Measles Public Exposure Location Map.

PREVENT

The best way to prevent measles is by age-appropriate measles vaccination.

Refer to Pediatric MMR Vaccine Recommendations (PDF) to guide measles immunization for children.
WA DOH has also issued Interim Pediatric Measles Outbreak Vaccination Recommendations (PDF) for individuals who live or travel to jurisdictions with an active measles outbreak.
WA DOH Office of Immunizations has a Measles Communications Toolkit (PDF) with information and guidance around effective measles communication.
For school immunization data for your jurisdiction, see our School Immunization Data Dashboard.

Background

Measles is a highly contagious acute febrile rash illness caused by infection with the measles virus, Measles morbillivirus. Illness generally begins with fever, cough, coryza (runny nose), and conjunctivitis (pink eye), followed 2–4 days later by characteristic maculopapular rash that starts on the face and spreads downward on the body. People infected with measles are contagious from 4 days before their rash starts through 4 days afterward; isolating during the infectious period is a key component of preventing additional cases of measles.

The virus is transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes. Measles virus can remain infectious in the air and on surfaces for up to 2 hours after an infected person leaves an area. Measles can cause severe health complications, including pneumonia, encephalitis, and death; In 2025, 12% of U.S. measles cases required hospitalization.

In Washington State, 12 measles cases were reported in 2025. No outbreaks of measles were identified in Washington last year.

Cases of measles are rising in the United States and around the world. As of early February, the CDC reported 733 cases of measles so far in 2026, linked to several large outbreaks across the United States. Most cases of measles in the US are among children and adolescents who had not received a measles vaccine or whose vaccination history was unknown.

Vaccination with a measles-containing vaccine remains the best way to protect against measles and its complications.