According to the Center for Disease Control, 30 states had reported a total of 935 confirmed measles cases as of May 1, 2025.
The United States declared the virus eliminated in 2000, but experts say a decrease in vaccination rates has led to the return of the virus. Three measles deaths have been reported so far; two unvaccinated school-age children in Texas and one unvaccinated adult in New Mexico.
Iowa has yet to report a confirmed measles case, but experts are preparing. Polk County Health Department Director Juliann Van Liew expects to see some cases pop up eventually, especially as nearby states Minnesota and Kansas experience outbreaks. The spread also has schools and child centers on alert.
The facts
Measles’ contagious nature at a time when national vaccination rates have decreased has created an environment for the disease to thrive. The CDC says nine out of 10 unvaccinated people exposed to the measles will contract it, and the virus can live in a room for up to two hours after the infected person leaves.
“There is one singular thing that folks can do immediately and hopefully many have done, and that is to get that vaccine,” Van Liew said.
Children are eligible for the MMR vaccine, or measles, mumps and rubella, at ages 12 months to 15 months. They receive a second dose as part of their kindergarten vaccinations, unless they have a certified exemption. One dose is 93% effective at preventing measles; two doses are 97% effective.
Across Iowa, 98.9% of school children were fully vaccinated, as were 96.8% of children in child care centers. While the rate of schoolchildren not fully vaccinated has increased in recent years, Van Liew believes that current vaccination rates will likely stymie the chance for outbreaks in Iowa that other states are seeing.
“Even though we do see vaccination rates slipping a bit, and that’s something to pay attention to, we do have pretty good coverage in most of our schools and day cares,” Van Liew said. “I don’t anticipate that we’re going to have huge outbreaks in our schools.”
Van Liew said the health department is focused on getting factual information to parents in ways they can understand and relate to. Refugee & Immigrant Voices in Action has also launched a campaign, “Voices for Health,” aimed at the same thing.
RIVA is training multilingual community health navigators to reach different communities of people with information on how to prevent measles and what to do if it’s contracted. Cecile Bendera, a public health student at the University of Iowa and a community health navigator, explained that connecting with groups in culturally appropriate ways is key to improving public health outcomes.
She is a refugee who speaks Swahili, allowing her to support the Congolese communities in Johnson County.
“We have to connect with the group that we’re trying to serve, because it is service work,” she said. “We collaborate with other community members. We’re trying to make sure this doesn’t disrupt their lives. We meet them at churches, grocery stores. … We reach them at the places where they’re carrying on their everyday lives so they don’t have to take time outside because we know their lives encompass a lot of things.”
Avoiding disruptions
Many parents anticipate missing some amount of work when their child becomes sick. For children with the measles, that time could be up to 21 days depending on when their infectious symptoms subside. A positive measles case requires full quarantine away from other people.
Those who are exposed but fully vaccinated don’t have to quarantine at all. Additionally, those who are unvaccinated and exposed to a positive case can return to school and work if they receive the first dose of the vaccination within three days.
“There really is a front line of protection here in a way for parents to be able to miss no work in these cases,” Van Liew said.
Health officials are closely monitoring schools, child care providers and other areas highly trafficked by children to track vaccination rates and understand risk factors. Van Liew said that knowing both your children’s and your own vaccination status, and having the appropriate documentation, can quicken the process of determining how long to quarantine if needed.
Children are required to have the MMR vaccines, unless exempted, at registered child care providers to protect babies in their care who are too young to receive it. EveryStep, a nonprofit offering health care and community services, has a team of child care nurse consultants who help child care providers keep a safe and healthy day care setting.
“They are registered nurses with backgrounds in a wide variety of pediatric and early childhood specializations,” said Molly Gosselink, EveryStep’s vice president of community health.
“They go and work with any day care on safety in the day care setting. They can also do lots of troubleshooting, which I think is where they get called on the most, especially around emerging diseases and infectious diseases.”
The child care nurse consultants currently provide high-level education about measles to child care providers in case the infection spreads to Iowa. The information explains the current situation in surrounding states and what to do if measles shows up in their spaces.
“One of the key ways that I see parents and day care centers collaborating is through prevention and knowing their immunization status and the immunization status of the children within their day care,” Gosselink said. “The child care nurse consultants can go and do mock audits with the day care so they can talk through the situations and follow up with parents if needed.”
The consultants can also help providers get vaccination records from other states when children move to the area.
Both Van Liew and Gosselink emphasize that while prevention through vaccination is the first step in combating a measles outbreak, isolation for infected individuals is also important. If you suspect you or your child has contracted the virus, quarantine immediately and call your health care provider.
“We’re worried about this minority, but I want to make sure that folks feel comfortable knowing that, by and large, the kiddos in Polk County [and across Iowa] are vaccinated,” Van Liew said. “We’re working really hard to fill those gaps, but we do audit and pay attention, so we know where those gaps are and if there are risks that are heightened, and we’re communicating that so if there are cases that show up in those spaces we’re able to respond quickly.”
Categories: Child CareHealth Care
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