Measles case confirmed in child on Oʻahu; DOH notifies public of exposure locations

The Hawaiʻi Department of Health State Laboratories Division confirmed a case of measles in an unvaccinated child under 5 years of age on Oʻahu. The DOH is investigating the case to identify those who might have been exposed and is working with them to prevent the spread of disease.

The child had recently returned from international travel with its parents. The child developed a fever, runny nose and cough shortly after returning to Hawaiʻi, sought medical care after breaking out in a rash, and is now recovering at home. A household member with similar symptoms is also being evaluated for possible measles infection.

Today, Gov. Josh Green signed emergency rules to help prevent a measles outbreak in Hawai‘i. The rules allow children with religious exemptions to receive the MMR vaccine while still retaining their exemption to other vaccines and staying in school.

“There’s no need to panic — but there is a need to act,” said Governor Green. “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.”

Measles, declared eliminated in the United States in 2000, is resurging. In 2025, more than 600 cases have already been reported across 22 states. Globally, cases have surged, with the World Health Organization estimating 10.3 million cases in 2023.

“We have a new confirmed case of measles in Hawai‘i,” said Dr. Kenneth Fink, Director of the Hawai‘i Department of Health. “The last confirmed case occurred in 2023, and additional travel-related cases are not unexpected. Our goal is to prevent cases from becoming outbreaks. 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 healthcare provider about getting vaccinated against measles to protect your ʻohana and our community.”

Statewide, Hawai‘i’s MMR vaccination rate stands at 89.8% — below the 95% threshold needed for community (or herd) immunity. Some schools have dangerously low coverage, especially on the Neighbor Islands.

“Hospitals and clinics across Hawai‘i are on high alert,” said Dr. Nadine Tenn Salle, Clinical Chair of Pediatrics at The Queen’s Health Systems. “We’re ready to identify and isolate cases, but our best defense is prevention. That means vaccination — not just for your child, but to protect newborns, the immunocompromised, and others who cannot be vaccinated. This is a community effort, and the medical community is here to help every step of the way.”

Members of the public may have been exposed to measles if they visited the following locations during the specified times:

• Daniel K. Inouye International Airport (HNL)
  • C gates, customs and baggage claim area on March 30 between 10:50 a.m. and 2 p.m.
  • Terminal 2 departures, TSA checkpoints and gate area for Delta flight 309 to Atlanta, Georgia, on April 4 between 1 and 7 p.m.
• Mānoa Valley District Park art class on April 1, between 9 to 10 a.m.
• Queen’s Island Urgent Care Kapahulu on April 4, between 8 a.m. to noon

Flight notifications have been issued for the airlines and airports through which the confirmed and suspected cases traveled. The DOH is also reaching out directly to individuals who had known contact with the confirmed or suspected case.

If you were at one of the above locations on the day and time specified:

• Not vaccinated? If you have never received a measles-containing vaccine (either the measles, mumps and rubella (MMR) vaccine or a measles-only vaccine which is available in other countries), you may be at risk of developing measles. Anyone who was exposed and considered to be at risk of developing measles should contact their healthcare provider immediately. Vaccine or immune globulin can be given to prevent measles if received shortly after exposure.
• Be vigilant. Watch for symptoms until three weeks after your last exposure. If you notice the symptoms of measles, immediately isolate yourself by staying home. Contact your healthcare provider right away. Call ahead before going to your healthcare provider’s office or the emergency room to notify them that you may have been exposed to measles and ask them to call the local health department. This call will help protect other patients and staff.
• Immunocompromised? Anyone with an immunocompromising condition should consult with their healthcare provider if they have questions or develop symptoms.
• Already vaccinated? If you have received two doses of a measles-containing vaccine, or were born before 1957, you are protected and do not need to take any action.
• Another dose? If you have received only one dose of a measles-containing vaccine, you are very likely to be protected and your risk of being infected with measles from any of these exposures is very low. However, to achieve complete immunity, contact your healthcare provider about getting a second vaccine dose.

A medical advisory will be issued to healthcare providers statewide.

Highly contagious

Measles is one of the most highly contagious viruses in the world. It spreads by direct contact with an infected person or through the air when an infected person coughs or sneezes. An infected person can spread measles to others from four days before developing the rash through four days afterward. The virus can remain in the air for up to two hours after an infected person has left the room.

Symptoms of measles

Measles symptoms typically include fever of greater than 101 F, runny nose, watery red eyes and a cough. These symptoms usually start seven to 14 days after being exposed. Three to five days after symptoms start, a rash begins to appear on the face and spread to the rest of the body.

How to protect yourself

The best protection against measles is the MMR (measles, mumps, rubella) vaccine. All children should receive two doses of the MMR vaccine. The first dose is given at age 12-15 months and the second dose at 4-6 years of age. If you are planning travel, consult your healthcare provider to determine whether an additional or earlier dose of MMR is recommended.

All adults born during or after 1957 should also have documentation of at least one MMR vaccination, unless they have had a blood test showing they are immune to measles or have had the disease. Certain adults at higher risk of exposure to measles (e.g., post-secondary school students, international travelers and healthcare personnel) need a second dose of MMR vaccine, at least four weeks after the first dose.

If you are exposed and not protected

If you are not protected against measles and are exposed to someone with the disease, contact your healthcare provider immediately:

• The MMR vaccine may prevent or lessen the severity of measles if given with 72 hours of exposure
• Immune globulin (a blood product containing antibodies to the measles virus) may prevent or lessen the severity of measles if given within six days of exposure.

If you are not protected against measles, believe you have been exposed and cannot reach your healthcare provider promptly, please call the DOH Disease Reporting Line at 808-586-4586, or call the Disease Investigation Branch at 808-586-8362.

There is no specific treatment for measles. Care of patients with measles consists mainly of ensuring adequate intake of fluids, bed rest and fever control. Patients with complications may need treatment specific to their problem.

Contact your healthcare provider to get the MMR vaccine, or locate a vaccine provider at https://www.vaccines.gov/en/

For more information about measles, visit:

• DOH measles information website
• CDC measles website
• MMR vaccine factsheet