Measles Concerns Spike in North Carolina

ASHEVILLE, N.C. — In the early hours of the morning, twin boys aged 7 were brought to Mission Hospital. They displayed several concerning symptoms: fever, cough, rash, pink eye, and cold-like symptoms.

The boys waited in different areas of the emergency room for over two hours before they were finally placed in isolation. Additional time passed before a call was made to the state epidemiologist to discuss their symptoms. The advice was clear: keep the children quarantined in the hospital. Soon after, the diagnosis was confirmed—measles.

The hospital staff provided guidance to the father about quarantine protocols and then sent the family home. Federal investigators later established that the virus may have exposed at least 26 others in the hospital that day. An inspection conducted by the Centers for Medicare & Medicaid Services (CMS) revealed that symptoms should have prompted immediate isolation—a procedure Mission Hospital staff had been trained on just months prior. Consequently, the hospital was categorized as being in “Immediate Jeopardy,” facing potential cuts to federal funding unless they addressed these issues.

A spokesperson for Mission assured that staff were trained to handle airborne illnesses and were adhering to federal guidelines.

Measles Outbreaks and Vaccine Hesitancy

As measles cases rise across U.S. hospitals, there’s notable pressure on health care workers to quickly identify the virus. But, many are unaware of what measles looks like. “There’s a term, ‘morbilliform,’ which refers to measles-like rashes, yet many viruses can cause similar appearances in children,” explained Theresa Flynn, a pediatrician and North Carolina Pediatric Society president. Remarkably, despite her three decades of experience, she’s never encountered a measles case.

Since mid-December, North Carolina reported over 20 cases, with more than 3,000 nationwide since January. Areas with low vaccination rates have seen particularly severe outbreaks, prompting public health initiatives to promote measles vaccination. CMS Administrator Mehmet Oz has publicly advocated for vaccination.

With two doses of the MMR (measles, mumps, rubella) vaccine, the chances of contracting the virus post-exposure are about 3%. In contrast, unvaccinated individuals face a staggering 90% risk of infection if exposed. Symptoms of the virus might not manifest for a week or two, which complicates early recognition.

Yet, skepticism about vaccine effectiveness has escalated, particularly after the Trump administration voiced doubts. Health and Human Services Secretary Robert F. Kennedy Jr., previously an anti-vaccine advocate, has shifted CDC recommendations, reducing the number of vaccinations suggested for children.

Following recent outbreaks in West Texas, Kennedy suggested various non-standard treatments for measles, none of which are scientifically verified.

Experts noted that due to the current policies, health care workers are left relying on personal experience or local public health systems to tackle this highly contagious disease, which often resembles common colds at first. “As we anticipate more measles cases, we’re all improving our ability to recognize and respond to it promptly,” Flynn added.

The Future of Measles in the U.S.

Officially, the U.S. has maintained its “measles elimination status” since 2000. However, given the recent outbreaks in places like Texas, Arizona, Utah, and now South Carolina, the nation is at risk of losing this designation by year-end.

One county in South Carolina has reported over 900 cases recently, surpassing Texas’ total for the entire previous year. Symptoms of measles include fever, cough, and a blotchy rash, and it’s considered highly contagious, capable of remaining active in the air for two hours post-exposure.

Fatalities can occur as well, with statistics indicating that 1 to 3 out of every 1,000 children infected may succumb to respiratory or neurological complications. In 2025, measles resulted in deaths of two children in Texas and one adult in New Mexico.

Support and Preparedness

The CDC has been working to equip clinics with information on diagnosing measles. Many state health agencies have created tracking systems to monitor outbreaks in locations such as hospitals, schools, and airports. Guidelines advise healthcare workers to look for the “three C’s”: cough, coryza, and conjunctivitis. Unfortunately, documentation revealed that Mission Hospital didn’t have a correctly designated isolation area for patients showing respiratory symptoms.

Despite assurances from a Mission spokesperson that measures were in place to manage airborne diseases, challenges remain. “We are collaborating with health officials proactively and are adhering to CDC guidance,” the spokesperson stated.

Notably, many healthcare settings across the U.S. have not had firsthand experience with measles. Patsy Stinchfield, a nurse practitioner and former president of the National Foundation for Infectious Diseases, expressed concern over the severity of CMS’ Immediate Jeopardy designation, citing the difficulty in identifying measles in an environment filled with other common viral infections, especially in winter. “It resembles every other viral respiratory infection, making it tough to pinpoint,” she noted.

Anticipating Future Cases

In Buncombe County, where Asheville and Mission Hospital are located, health officials have recorded seven measles cases by mid-February, expecting a rise in numbers. The exact connection to the exposure at Mission remains uncertain.

Officials are bracing for a potentially escalating situation akin to South Carolina, where they might see a gradual increase in cases that could suddenly surge. Recently, a local private school quarantined around 100 students due to an exposure, revealing that only 41% of attendees were vaccinated.

At Flynn’s clinic, precautions are being taken, urging parents to remain in their vehicles as staff conduct screenings. However, some parents express hesitance about vaccinations, influenced by recent watering down of federal vaccine recommendations for young children.

With Kennedy having appointed committee members involved in spreading medical misinformation, it’s created further concerns. One reportedly told a nurse, “It’s just measles. It doesn’t kill anyone.” Flynn and her team feel it’s vital to counter such misconceptions, particularly when many understand so little about the real risks involved with measles.

As they navigate these challenges, messaging around vaccination and the importance of proactive measures has never been more crucial. “We can’t change what has already happened,” Flynn reflected. “We can only focus on education and progressing forward for the sake of our communities.”