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Health officials this weekend said a fourth measles case has been detected in the state this year, after a Maryland resident living in the Washington, D.C., area contracted the respiratory virus while traveling internationally.
It’s the most cases detected in a single year since 2019, when five cases were reported in the state. The Maryland Department of Health announced the first measles case back in April, and all four cases this year were people who had traveled outside the state, two of them internationally.
Despite the growing number of cases, Dr. William Moss, a professor with Johns Hopkins Bloomberg School of Public Health, said the trend reflects increases in measles activity across the globe and is not an effective indication of measles activity in Maryland specifically.
“We in Maryland are going to have importations of measles cases into our state as long as there are cases occurring elsewhere,” Moss said. “The good news is that we have not had sustained outbreaks or sustained transmission of measles virus.”
He says that the state’s relatively high vaccination rate against measles, with over 96% of Marylanders vaccinated, largely protects it from additional transmission, unlike other states with lower vaccination uptake.
Deputy Health Secretary for Public Health Services Dr. Meg Sullivan said in a written statement that vaccinations remain “essential to protecting ourselves, our families, and our communities against measles and other infectious diseases,” and she urged Marylanders to get vaccinated if they are among those who have not already done so.
“Talk with your healthcare provider to ensure you and your family are up to date with all recommended vaccines, including the MMR vaccine,” Sullivan said in the written statement Saturday, referring to the combined vaccination against mumps, measles and rubella.
Maryland children are required to receive a series of vaccines, including against measles, before entering kindergarten. But families can opt their children out of those requirement, and a growing number are doing so through nonmedical exemptions.
That said, the rate of exemption is still low: Less than 2% of kindergarteners had a nonmedical exemption from required vaccination in the 2024-2025 school year.
Meanwhile, health officials are working to identify and notify those who may have been exposed to the virus this month. The department is urging Marylanders who traveled through Washington Dulles International Airport in mid-June to monitor for symptoms of measles, as they may have been exposed to the infected individual.
Measles virus can linger in the air for up to two hours after an infected person leaves the room, potentially exposing a high number of people if passing through a high-foot-traffic such as an airport. The virus can also spread after touching infected surfaces or through direct contact.
The individual at the center of the most recent measles case is a Maryland resident in the Washington area who traveled abroad and returned to the states on June 17 through Dulles.
Between 6 a.m. and 11 a.m., the individual arrived in Concourse C, took transportation to the International Arrivals Building and passed through the baggage claim area. The individual also went to the Mary’s Center Adams Morgan Clinic in Washington, D.C., that afternoon between 4 p.m. and 8:30 p.m.
The health department says Marylanders who may have shared those spaces on June 17 with the infected individual should first confirm their vaccination status. Those with a record of two measles vaccinations, or who were born before 1957, are generally considered protected.
But those who are underimmunized at the time of the exposure should contact their health provider or local health departments to see if post-exposure treatments would be beneficial for the potentially exposed individual.
Importantly, those who are not immunized and may have come into contact with the infected person should monitor for symptoms in the coming days, as symptoms can develop as soon as seven days after exposure to as late as 21 days. Most people will see symptoms develop 10-14 days after exposure.
Measles infection symptoms start with a fever of over 101 degrees, cough, runny nose, red and watering eyes. Days later, the virus’s telltale rash may emerge, starting on the face and spreading to the rest of the body.
Some who are vaccinated might still develop symptoms if exposed to the virus in what are called “breakthrough cases.” But Moss emphasizes that “vaccination is the key” to avoiding severe infection in those situations as well.
“No vaccine is perfect,” Moss said, “but it’s a very effective vaccine, and those individuals, even if they do have a breakthrough case, are going to have a milder disease.”