What You Need To Know
Public Health Message Type: ☒ Alert ☐ Advisory ☐ Update ☐ Information
Intended Audience: ☒ All public health partners ☒ Healthcare providers ☒ Infection preventionists
☒ Local health departments ☒ Schools/childcare centers ☐ ACOs
☐ Animal health professionals ☐ Other
Summary:
- On Wednesday, March 19, 2025, a confirmed measles case traveled from Penn Station, New York, via Amtrak Northeast Regional 175 Train Southbound, passing through NJ. The individual is not a NJ resident. The exposure timeframe is March 19, 7:30 pm - 1:30 am.
- Providers should remain vigilant and consider measles in people with a febrile rash illness lasting three days or more, a fever of 101°F (38.3°C) or higher, and clinically compatible symptoms (cough, coryza and/or conjunctivitis), particularly if the person was potentially exposed to a case of measles or has recently traveled internationally.
- Providers who are ordering measles testing should obtain samples from the following sites: oropharyngeal/nasopharyngeal swab (rRT-PCR), urine (rRT-PCR), and serum (measles IgM and IgG).
- Providers should implement measles prevention measures by ensuring they and their staff are up-to-date with immunizations, triage patients by telephone, isolate patients upon arrival and have access to and are trained to use appropriate personal protective equipment (PPE) when interacting with patients.
- Providers should ensure their patients are up to date on recommended immunizations including MMR. Prior to international travel, everyone 6 months and older may be eligible for MMR.
- Measles is an IMMEDIATELY reportable condition, and providers should immediately report suspected cases of measles to local public health authorities where the patient resides, or if not available, to the NJDOH at (609) 826-5964 during regular business hours or (609) 392-2020 after business hours or on the weekend.
- Measles cases continue to be identified across the country with 18 jurisdictions reporting cases in 2025, including Alaska, California, Florida, Georgia, Kansas, Kentucky, Maryland, Michigan, New Jersey, New Mexico, New York City, New York State, Ohio, Pennsylvania, Rhode Island, Texas, Vermont, and Washington. 95% of these cases are unvaccinated or have unknown vaccination status.
Background
The New Jersey Department of Health (NJDOH) Communicable Disease Service would like to make you aware that a non-NJ resident confirmed case of measles potentially exposed residents in multiple states, including
NJ. The individual boarded the Amtrak Northeast Regional 175 Train Southbound at Penn Station in New York around 7:30 p.m. on March 19, arriving at Union Station in D.C. around 1:30 a.m. (March 20). The DC Health press release is available here:
https://dchealth.dc.gov/release/health-officials-investigating-possible-measles-exposures-dc
Anyone who traveled on Amtrak Northeast Regional 175 Train Southbound only on March 19 from 7:30pm through 1:30am (March 20), may have been exposed to measles. As of today, the NJDOH has not been notified of NJ residents known to have been exposed. If infected, individuals would be expected to develop symptoms of measles no later than April 9.
As of March 26, there are a total of 3 measles cases in NJ in 2025. There is no on-going community transmission of measles in NJ at this time. A total of 7 measles cases were reported in NJ in 2024.
The NJDOH would also like to make you aware that from January 1 to March 20, 2025, the CDC has been notified of 378 confirmed cases of measles across 18 jurisdictions in the U.S., including 3 outbreaks. Two deaths have been reported (1 confirmed, 1 under investigation). There is an on-going outbreak occurring in Texas with spread to New Mexico. 95% of the cases reported in the U.S. for 2025 are among children and individuals who had not received measles-mumps-rubella (MMR) vaccine or have unknown vaccination status. In 2024, there were a total of 285 measles cases reported across the country.
Therefore, the NJDOH requests healthcare providers maintain vigilance for measles among patients who meet the clinical criterion for measles (generalized maculopapular rash lasting 3 or more days, fever at least 101°F (38.3°C), and cough, coryza, or conjunctivitis). Take a detailed history to determine the individual’s travel history, contact with travelers or other possible exposures, vaccination status, and detailed history of present illness including symptoms, symptom onset dates and rash progression. Report all patients that are suspected of having measles IMMEDIATELY to local health department where the patient resides or, if not available, to the NJDOH.
Measles Specimen Collection and Testing
The NJDOH advises healthcare providers to collect specimens from patients suspected of having measles as early as possible in the course of illness. Efforts should be made to obtain specimens from suspected cases at first contact and testing should be expedited and coordinated with the local health department.
When there is a high index of suspicion, measles PCR testing is the preferred testing methodology, which is performed at the NJDOH Public Health and Environmental Laboratory. Approval is required by NJDOH prior to submission.
The following specimens should be obtained:
- Nasopharyngeal (NP) or throat swab for PCR testing - preferred (hold for NJDOH submission approval)
- Serum for measles IgM and IgG testing (send to commercial laboratory)
- Acute phase serum as soon as possible and convalescent serum 2-3 weeks later
- Collect minimum of 2 ml of blood in a red top or serum separator tube (red-speckled or gold).
- PLEASE NOTE:
- If serology is being ordered to determine measles immunity, commercial IgG testing is recommended. Do NOT order measles IgM if the patient is asymptomatic or recently vaccinated with MMR.
- Serologic test results should be interpreted with caution, as false-positive and false-negative results are possible with IgM tests.
- Urine specimens should only be collected if an NP or throat swab is not able to be collected.
Please see the NJDOH Quick Guide for Measles Specimen Collection and Testing and Measles Laboratory Testing FAQs for more information.
Infection control considerations for suspected cases of measles
The NJDOH requests that all healthcare providers maintain a high index of suspicion for measles in persons with a febrile rash illness, especially in those persons with recent international travel or visit to a community with an on-going measles outbreak. Because measles is highly infectious and the virus can remain airborne up to two hours, providers should take precautions to minimize exposure if one of their patients is suspected of having measles:
- Advise patients who call about a febrile rash illness to minimize exposure to others
- Post signage outside of the office notifying patients with rash to call BEFORE entering
- Should a suspected case present for care, place a mask on patient and isolate immediately
- Arrange for an exam in an isolated area. The exam room should not be used for at least 2 hours after the measles suspect leaves
- Review vaccine records or titer reports for your staff now, to ensure that only those with evidence of immunity to measles provide care to a suspected case of measles.
- People presumed to be immune to measles are those:
- Born in the US before 1957
- This is insufficient for healthcare workers.
- Have documentation of receipt of two doses of live measles-containing vaccine (MMR)
- Have documentation of a positive measles IgG titer
- Remind providers/staff about the importance of receiving up-to-date immunizations and using appropriate precautions and personal protective equipment (PPE) when interacting with patients.
Prevention of Measles
- The best way to prevent measles is to remain up to date on all measles vaccinations especially when considering traveling abroad.
- The following people should be vaccinated against measles:
- All children over one year of age who have not yet been vaccinated
- Children between 6 months and 1 year of age who will be traveling internationally or visiting a community with an on-going measles outbreak (This dose will not count toward the primary series and two additional doses after one year of age will still be required.)
- Adults who have not yet been vaccinated and were born after 1957 and not had laboratory confirmation of a previous measles infection.
- Adults of any age who will be traveling internationally or visiting a community with an on-going measles outbreak who have not previously received two doses of MMR.
The New Jersey Department of Health's licensing standards for health facilities require that facilities notify the Department of reportable events in accordance with all applicable State and Federal regulations. New Jersey Administrative Code (N.J.A.C.) 8:43-10.11(e) states “A health care facility shall report incidents of infectious and communicable diseases to the Department pursuant to N.J.A.C. 8:57.” Filing a report via the NJDOH web-based electronic “Non-LTC Reportables Survey” DOES NOT satisfy communicable disease reporting regulations set forth in N.J.A.C. 8:57.
The NJDOH reminds healthcare providers that measles is immediately reportable upon suspicion, and to report suspected cases of measles to the local health department where the patient resides, or if not available to the NJDOH Communicable Disease Service at (609) 826-5964 during regular business hours or (609) 392-2020 after business hours or on the weekend.
New Jersey Department of Health Measles Website
Considerations when Evaluating a Person for Exposure to Measles in a Healthcare Setting
Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings