Measles outbreaks have been increasing throughout the United States. This is a resurgence of an illness that had been eradicated in this country. Employers will need a plan to prepare for and respond to measles outbreaks in the workplace.

How much are measles outbreaks increasing?

According to the Centers for Disease Control, as of July 9, 2025, there have been 1,288 confirmed cases of the measles this year in the U.S., reaching 38 states. This is the highest number of any year since the United States declared measles eliminated in 2000, surpassing even the 2019 outbreak. While New Mexico, Oklahoma and Texas have had the highest number of cases, measles has been reported in the majority of U.S. states.

What is causing the increase?

Despite a continued increase in the number of cases, the overall risk of contracting measles remains relatively low due to the higher immunization rates in the adult population in the United States.

Lower vaccination rates among certain subsets of the population have largely been to blame for the resurgence of cases. The majority of cases have appeared in unvaccinated children under 18. According to CNN, as of 2024, only 68.5% of children had received their first dose by 15 months of age.

International travel is historically one of the most common causes of measles outbreaks in the United States. The highest rate of international travel to and from the U.S. occurs in the summer months, making this season an important time for employers to review their policies and ensure they are prepared in case of any measles exposures at the workplace.

How contagious is measles?

Measles is a highly contagious virus that is generally spread by sneezing, coughing and breathing airborne particles. If one person has measles, up to 9 out of 10 people nearby will become infected if they are not protected, according to the CDC.

How effective is the MMR vaccine?

The best protection against measles is the MMR vaccine, one dose of which is 93% effective, with two doses raising the efficacy to 97%, the CDC reports. Unlike influenza or COVID, measles is a very stable virus. In 2021, a Mayo Clinic study concluded that there is a near-zero probability of a novel measles virus naturally emerging with the capability of circumventing the MMR vaccine.

What are common symptoms of measles?

Common measles symptoms include: high fever, cough, runny nose, red and watery eyes, and a rash (usually starting on the face), according to the CDC.

How serious is measles?

For some people, measles can be quite serious. The CDC’s website warns that “Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die.”  It also explains that “about 1 in 5 unvaccinated people in the U.S. who get measles is hospitalized.” Children are particularly at risk. The CDC warns that “nearly 1 to 3 of every 1,000 children who become infected with measles will die from respiratory and neurologic complications.”

What is the exposure period, and how does it spread?

Measles is highly contagious. Public health experts recommend that at least 95% of a community be vaccinated to provide as much protection as possible.

Symptoms appear seven to 14 days after contact with the virus, and individuals are infectious four days before symptom onset and four days after symptoms clear, the CDC says. Measles is airborne, and the virus remains active in the air and on infected surfaces for up to two hours after the infected person departs the area. Measles can be spread without close contact with an infected person, according to health experts, meaning an infected person can spread the disease even before knowing they have it.

As an employer, what should I do?

The CDC and EEOC have not yet issued specific guidelines regarding measles. Many regulations are based on guidance from other infectious diseases or state regulations and guidance. Still, having a plan for a potential measles outbreak is the best way to reduce risk, liability and keep employees safe.

Here are a few steps to consider when managing a measles exposure in the workplace.

1. Notify local health departments.

Upon receiving notification of an employee’s measles infection, employers should let the state or county health department know about the confirmed diagnosis. Local health departments are equipped with information about measles and can provide resource materials and guidance on further actions to limit risk to other individuals. Formulating a thoughtful plan in concert with a local health department will enable employers to communicate objective and accurate information to employees.

2. Send the infected employee home.

If an employee notifies you that they received a measles diagnosis and are infected, you should send that employee home. Employers should review their policies to evaluate options for the needed time off. Generally, a variety of types of leave time will be available, including state or local mandatory paid sick leave, paid time off or leave under the Family and Medical Leave Act (FMLA) or state analogs to the FMLA, if eligible. If an employee does not have enough PTO to cover the time needed to recuperate, employers should engage in the interactive process with the employee.

As with any leave taken by employees, employers cannot take any adverse employment action against the individual with the measles due to the diagnosis or any associated need for leave.

3. Notify exposed employees.

Employee privacy is vital when responding to a measles infection and addressing employee exposure. Employers should not share the identity of an employee infected with measles. When notifying employees of measles exposure, the employer should also advise employees that it has reviewed with local health officials and provide the applicable resource documents received from the health department.

The employer may opt to grant exposed employees PTO or an accommodation to work remotely if the employee is immunocompromised, cares for someone who is immunocompromised or has other concerns about the exposure. However, employers should ensure these requests are properly reviewed and evaluated and consistently apply reasonable accommodations procedures where applicable.

Is there anything else an employer can do?

In short, yes. There are many permissible actions available, including educating employees on facts surrounding measles, the MMR vaccine, symptoms and exposure.

Employers may also encourage employees to voluntarily get vaccinated and provide information to employees about where to get vaccinated. Reimbursing for vaccinations is also likely permissible.

If there is an active outbreak, employers may be able to inquire about employees’ vaccine status. However, this is highly dependent on state laws and regulations and should be done in consultation with counsel. If permitted to inquire, employers must ensure all private information is kept confidential and ensure individuals are not singled out.

It is also prudent to train HR and managers on what to do if a measles exposure is reported.

Can an employer require MMR vaccines?

Certain employers, such as health care organizations, have long required the MMR vaccine as a condition of employment. However, in recent years, there has been increasing polarization around vaccines and, in turn, litigation around mandatory vaccination programs.

The employer will want to weigh carefully the workplace risk associated with measles and the health and safety benefits of requiring the vaccine. This may involve, for example, reviewing the workplace setting, any contact between employees and vulnerable populations, and the vaccination rate of the workforce and community.

Any mandatory vaccination policy should be carefully considered in consultation with counsel to ensure compliance with federal law as well as the growing number of intersecting state and local laws that have been enacted since the COVID-19 pandemic.