Minnesota health officials issued an urgent warning after an unvaccinated child with measles visited Mall of America while infectious. The child from Dakota County spent time at the mall’s theme park on May 24 between 5 pm and 9 pm. Thousands of visitors may have been exposed to this highly contagious viral disease during this 4-hour window.
Health authorities express particular concern because the child’s infection source remains unknown. Jessica Hancock-Allen, Minnesota’s infectious disease division director, called this “worrying” as it suggests community spread.
Minnesota health officials also cautioned visitors who were at Mall of America during the exposure window. They have urged those patrons to monitor for symptoms until June 14. Unvaccinated individuals or those who have not had measles before face the highest risk of infection. These groups are also at high risk for more serious complications arising from this disease. The mall has implemented enhanced sanitation protocols while working with health officials on contact tracing.
Minnesota Confirms New Measles Cases
Minnesota reported two additional measles cases in early June, bringing the state’s 2025 total to 4 confirmed infections. The first case involves the unvaccinated child at Mall of America, while the second affects a Washington County adult. The adult contracted measles during domestic air travel outside Minnesota, with their vaccination status still being unknown.
Both patients are recovering at home under medical supervision and public health monitoring. State health officials are working with local departments to identify and contact potential exposures from both cases. Minnesota experienced 70 measles cases in 2024, with 40% requiring hospitalization for serious complications.
National Measles Outbreak Reaches Critical Levels
The United States faces its largest measles outbreak since 2019, with 1,168 confirmed cases across 34 jurisdictions as of June 5, 2025. This represents a quadrupling of cases compared to the 285 infections reported throughout 2024. 17 separate outbreaks account for 89% of all confirmed measles cases this year. Most infections cluster in close-knit communities with low vaccination coverage, allowing the rapid spread of the disease.
3 deaths have been confirmed nationally, including 2 unvaccinated school-aged children in Texas. New Mexico reported one additional death in an unvaccinated adult who tested positive post-mortem. All fatalities occurred in individuals who had not received MMR vaccination. The current outbreak approaches the 1,274 cases recorded in 2019, potentially becoming the worst in 3 decades. Public health experts warn that continued vaccination decline could make measles endemic again.
Declining Vaccination Rates Fuel Disease Spread
The state’s vaccination rates have declined significantly since the pandemic began citing reluctance and misinformation, impacting community immunity. In 2019, over 92% of Minnesota kindergarteners received full MMR vaccination compared to 87% in 2024. This decline below the 95% threshold needed for herd immunity creates vulnerability to outbreaks.
Of 2,066 counties studied, 1,614 counties (78%) reported declining MMR vaccination coverage. Only 4 states, namely, California, Connecticut, Maine, and New York, showed increased median vaccination rates. Vaccine hesitancy and misinformation contribute significantly to reduced immunization rates nationwide.
Stanford Medicine researchers predict that measles could become endemic within 2 decades if current trends continue. Even small additional declines in vaccination coverage would accelerate this timeline significantly. Conversely, modest increases in vaccine uptake could prevent a resurgence of measles in America.
Understanding Measles Transmission and Symptoms
Measles is highly contagious and spreads through airborne respiratory droplets when infected people come into contact with uninfected individuals. The virus can survive in air spaces for up to 2 hours after infected individuals leave the area. This exceptional persistence makes measles extremely contagious, with up to 90% of unvaccinated close contacts becoming infected.
The first symptoms appear 7-14 days after exposure and resemble common cold symptoms. Patients develop high fever (often exceeding 104°F), persistent cough, runny nose, and red watery eyes. Small white spots called Koplik spots may appear inside the mouth 2-3 days after symptoms begin appearing.
The characteristic measles rash emerges 3-5 days after initial symptoms begin. Red, flat spots start on the face and spread downward to the neck, trunk, arms, legs, and feet. As the rash appears, fever typically spikes even higher, sometimes reaching 105.8°F.
Infected individuals remain contagious for eight days total. The 4 days before the rash appears through 4 days after visible symptoms begin to appear.
High-Risk Groups and Complications
Infants under 12 months face the highest risk for severe measles complications and death. These babies cannot receive the MMR vaccination and depend entirely on community immunity for protection. Unvaccinated children under 5 years also experience more severe illness, higher complication rates and even death.
Pregnant women without immunity risk miscarriage, premature birth, and maternal death from measles infection. Immunocompromised individuals, including cancer patients and organ transplant recipients, who have weakened immune systems are vulnerable.
Common complications include pneumonia (6% of cases), middle ear infections (7%), and diarrhea (8%). Severe complications encompass brain inflammation (encephalitis), seizures, and blindness in some patients. About one in 1,000 children with measles develops brain swelling that can cause permanent brain damage.
Hospitalization becomes necessary for approximately 20% of unvaccinated measles patients. Death occurs in 1-3 of every 1,000 infected children, making measles potentially fatal. This emphasizes the necessity not only for individuals to vaccinate but entire communities to protect vulnerable populations.
Prevention Through Vaccination
The MMR vaccine provides 97% effectiveness against measles when both doses are administered correctly. Children receive the first dose at 12-15 months and the second at 4-6 years of age. This 2-dose schedule ensures optimal protection and addresses any primary vaccine failures.
Single-dose effectiveness ranges from 85-95%, while two doses approach 100% protection. Adults born before 1957 are considered naturally immune due to widespread disease circulation. Adults born after 1957 should verify immunity through vaccination records or blood tests.
Public Health Response and Contact Tracing
Healthcare facilities receive alerts to maintain airborne precautions for suspected measles patients. Suspected cases require immediate isolation for 4 days after the rash appears.The CDC issued health alerts to healthcare providers nationwide emphasizing vaccination importance.
Preventing Future Outbreaks
Restoring high vaccination uptake remains the best method for mitigating future measles outbreaks. Communities need to achieve and maintain 95% MMR vaccination rates to ensure effective herd immunity. Healthcare providers play major roles in educating parents about vaccine safety and importance. Addressing vaccine hesitancy requires clear communication about measles risks versus vaccine benefits. Combating misinformation through evidence-based education helps restore public confidence in immunization programs.
