North Carolina Measles Total Reaches 22, Mostly Unvaccinated Children

State health officials reported 22 confirmed measles cases in North Carolina since late December 2025, with 17 of those infections in children and most cases affecting unvaccinated people, the North Carolina Department of Health and Human Services said in its Feb. 17 update. NCDHHS wrote, “NCDHHS continues to recommend all unvaccinated individuals ages one year and older receive the measles, mumps, rubella (MMR) vaccine to protect themselves and those around them.”

The department also advised clinicians and parents to consider giving MMR earlier than usual for some infants. NCDHHS recommended providers “consider early vaccination for infants 6 to 11 months of age residing in, or spending time in, areas of North Carolina where measles transmission is occurring,” and specifically named Buncombe County and the Charlotte metropolitan area, Cabarrus, Gaston, Iredell, Lincoln, Mecklenburg, Rowan and Union counties, as places where early vaccination should be considered.

County-level reporting shows clusters in western and central North Carolina. WRAL reported seven cases in Buncombe County and five cases in Polk County, with the Polk case count bringing the statewide total to 22. Johnston County recorded a case in early February, the first in that county since 2018, after the patient visited the emergency department at UNC Health Johnston in Smithfield. PulmonologyAdvisor reported one child hospitalized in Nash County.

Public-health investigators have documented exposures in retail and fitness settings across the Triangle and elsewhere. A person visiting from South Carolina who had measles visited five locations in Raleigh’s Brier Creek area on Feb. 5, including a gym, two grocery stores, a pharmacy and a restaurant, PulmonologyAdvisor reported. The next day, Feb. 6, someone with measles visited three businesses in Durham, including a thrift store and a restaurant. WRAL warned spread could appear soon in the Triangle and said some Charlotte-region cases have not been linked to travel, indicating local person-to-person spread.

Health officials reiterated how contagious measles is and described common symptoms. WECT reported symptoms can appear 7 to 21 days after exposure, while WLOS cited a 7 to 14-day window; both outlets listed high fever, cough, runny nose, red watery eyes and a spreading red rash. Wake County public health director Rebecca Kaufman warned about airborne persistence: “Even just being in the same room as someone who up to two hours earlier was there with the measles, you can contract the virus.” Asheville pediatrician Dr. Bridget Fogelman added the clinical stakes: “It’s scary. One out of three children less than 5 years of age will be hospitalized from some complication with measles. Pneumonia can happen in 1 out of 20 unvaccinated children.”

State epidemiologists emphasized prevention and early consultation with providers. Dr. Zack Moore, NCDHHS State Epidemiologist, said, “The rise in measles cases is concerning, especially since most infections are affecting unvaccinated children. Measles is highly contagious, but it is also preventable. We strongly encourage parents in areas where there has been community transmission of measles to speak with their health care provider about the option of early vaccination for infants 6 to 11 months old.” PulmonologyAdvisor reported that 72% of cases involved people who were not vaccinated and that most cases were younger than 18.

Hospitals are taking containment steps when suspected cases arrive. Tommy Williams, CEO of UNC Health Johnston, described the emergency department response: “As soon as the patient arrived, our emergency department team quickly masked and moved the patient to … limit exposure.” State guidance and media reports urge anyone with symptoms or possible exposure to call their local health department, limit contact with others and call ahead before visiting clinics or emergency departments. With a large outbreak continuing in upstate South Carolina, reported by WRAL at more than 930 cases and described by WLOS as approaching 1,000, NCDHHS cautioned that vaccination and rapid reporting remain the most immediate tools to limit spread.