The inevitable has happened, with Hawaii’s first confirmed case of travel-related measles in the state this year as the number in the U.S. surges beyond 600.
The state Department of Health on Tuesday announced the measles case in an unvaccinated child on Oahu under the age of 5. It was confirmed Monday night, according to Gov. Josh Green, in a child who recently returned from international travel with family.
“There’s no need to panic — but there is a need to act,” said Green in a statement after a news conference Tuesday. “Measles isn’t just a rash and a fever — it’s one of the most contagious viruses known. We’ve already seen what happens when vaccination rates drop: more cases, more outbreaks, more lives at risk. The best thing you can do to protect your family, your community and our keiki is to get vaccinated. It’s simple, it’s safe and it saves lives.”
Health officials said the child developed a fever, runny nose and cough shortly after returning to Hawaii, and sought medical care after breaking out in a rash.
The child is now recovering at home on Oahu, DOH said, and a household member with similar symptoms is being evaluated for possible measles infection.
DOH is investigating the case and contacting people who may have been exposed. Officials have issued flight notifications and sent an alert to health care providers statewide.
“The kid’s doing well, by all accounts,” said Green, “so we send our love and prayers to them.”
But, he warned, measles is a very contagious disease that spreads through the air and can linger in a room for up to two hours. It can also overwhelm a community quickly.
According to DOH, 9 out of 10 people without immunity exposed to a person with measles will become infected. Measles can spread to others through coughing, sneezing and contaminated surfaces.
“Let me be really clear: You’re sitting near somebody with the measles and you’re not vaccinated, you’ve got a really good chance to catch it,” said Green. “I mean, this stuff is infectious, so it’s very important that you listen carefully to our Department of Health officials to find out if you happened to be in that lounge with them, or on the plane with them, or at a play date.”
Measles also can result in serious complications including pneumonia and encephalitis, or inflammation of the brain.
The best way to prevent measles, said DOH, is through the measles, mumps and rubella vaccine, which is part of routine childhood immunizations.
The U.S. declared measles eliminated in 2000 when vaccination rates were high, but cases are now resurging as those rates decline.
Green has approved emergency rules allowing a child with a religious exemption to receive an MMR vaccine while still retaining their exemption to other vaccines and staying in school.
DOH Director Kenneth Fink said additional travel-related cases are not unexpected.
“Our goal is to prevent cases from becoming outbreaks,” said Fink. “The best way to prevent an outbreak is to have at least a 95% community vaccination rate. The MMR vaccine is safe and effective. If you or a family member are not up to date, please talk with your health care provider about getting vaccinated against measles to protect your ohana and our community.”
Hawaii’s MMR vaccination rate has dropped to 89.8%, below the 95% threshold needed for herd immunity and below the national average of 93%.
Some schools have dangerously low coverage, DOH said, especially on neighbor isles.
Hawaii last detected measles two years ago. In April 2023, DOH reported one case of measles in an unvaccinated Oahu resident returning from international travel.
Several weeks later DOH reported a second case in an Oahu resident who was exposed to the first case.
On the mainland, meanwhile, the number of confirmed measles cases has grown to at least 607 in 22 states, mostly in Texas but also in New Mexico, Oklahoma and Kansas.
Two school-age children have died from the measles outbreak in Texas, with the most recent death being an 8-year-old girl who was unvaccinated and previously in good health.
POSSIBLE OAHU MEASLES EXPOSURE
>> March 30, 10:50 a.m. to 2 p.m. at Daniel K. Inouye International Airport, C gates, customs and baggage claim area
>> April 1, 9 to 10 a.m. at Manoa Valley District Park art class
>> April 4, 8 a.m. to noon at Queen’s Island Urgent Care on Kapahulu Avenue
>> April 4, 1 to 7 p.m., Terminal 2 departure areas, TSA checkpoints and gate area for Delta Flight 309 to Atlanta
DOH urges anyone who may have been potentially exposed at these places and times — and who are not up to date on their MMR vaccines or unsure of their status — to contact their health care provider immediately. Watch for symptoms up to three weeks. Vaccine and immune globulin can be given to prevent measles if received shortly after exposure. If you cannot reach your health care provider, call the DOH disease reporting line at 808-586-4586.
Measles: What you should know
>> Measles is a very contagious rash illness caused by a virus.
>> An infected person can spread measles to others from four days before a rash develops to four days after.
>> In the U.S., about 1 in 5 unvaccinated people with measles are hospitalized due to complications, such as pneumonia, ear infections and encephalitis (brain swelling).
Prevention
Two doses of MMR vaccines are 97% effective, but breakthrough infections — which are uncommon — can occur during an outbreak. Adults born in or after 1957 should have at least one MMR vaccine or a blood test showing they are immune or have had the disease. Adults at higher risk of exposure need a second dose at least four weeks after the first one.
Symptoms include:
• High fever.
• Cough.
• Runny nose.
• Red, watery eyes.
• Rash breakout three to five days after symptoms begin.
Symptoms usually start seven to 14 days after infection.
