What You Need To Know
The New Jersey Department of Health (NJDOH) Communicable Disease Service would like to make you aware that measles virus was detected in a wastewater sample collected on March 20, 2026, from a treatment plant in Essex County that serves areas of Bergen, Passaic, Hudson, Union, and Essex counties. A subsequent sample taken on March 23, 2026, at the same site was negative. No clinical cases in New Jersey residents have been identified in this region. The last confirmed case of measles in NJ was in October 2025.
The measles test that was done detects wild-type measles virus; it does not detect the vaccine strain. Therefore, a detection of wild-type measles virus in wastewater means that people who currently have, or recently had, measles may be present in the community. This could include people who live or work in the community, or those who traveled through the community, including through Newark Liberty International Airport.
Wastewater surveillance detects viruses from infected people and can serve as an early warning system for infectious diseases (by sampling untreated sewage entering wastewater treatment plants). This detection does not mean there is an outbreak. Wastewater detections cannot be tied to individuals, but this positive wastewater test result indicates that there was at least one individual with measles who was in this region. Measles virus spreads through the air and close contact with an infected person. At this time, it is not known to spread through wastewater.
The New Jersey Public Health and Environmental Laboratories (NJPHEL) has been routinely testing for measles in wastewater samples from numerous locations around the state since September 2025. However, this recent detection was from one of six locations tested by the national commercial company, WastewaterSCAN. The Department was notified by WastewaterSCAN that a low level of measles virus was detected in a sample collected from an Essex County treatment plant. Further testing on additional samples will be performed by both NJPHEL and WastewaterSCAN next week.
Therefore, the NJDOH requests healthcare providers continue to 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 specimensshould be obtained:
- Nasopharyngeal (NP) or throat swab for PCR testing - preferred (hold for NJDOH submission approval)
- Serum for measlesIgM and IgG testing (send to commercial laboratory)
- Acute phase serum assoon as possible and convalescentserum 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.
Healthcare Providers
- Ensure all patients without other evidence of immunity, especially those planning international travel, are up to date on MMR vaccine per routine ACIP recommendations.
- Providers who administer vaccines are strongly encouraged to become New Jersey Immunization System (NJIIS) users and submit administration data. By using NJIIS for all patients, regardless of age, it allows for a single source of documentation for all immunizations administered.
- Utilize NJIIS reminder/recall function to identify children needing MMR vaccination o Empower patients by informing them if they have a vaccination record in NJIIS, it will then also be accessible to them for downloading through the Docket app (available for free download via Apple App Store or on Google Play).
- Establish documented evidence of immunity to measles now for all providers/staff and ensure access to status should an exposure occur.
- Implement screening/triage procedures: triage by telephone; post signage outside of the office notifying patients with rash to call BEFORE entering; mask and isolate (preferably in an airborne isolation room, if one is available) patients presenting with rash and fever immediately upon arrival; do not use exam room for at least 2 hours after a suspect measles leaves.
- Implement measles prevention measures
- Use a fit tested NIOSH-approved N95 or higher-level respirator.
- Remind providers/staff about the importance of using appropriate precautions.
- Ensure providers/staff have access to and are trained to use appropriate personal protective equipment (PPE) when interacting with patients.
- Review guidelines for post-exposure prophylaxis and identify points of access for persons needing MMR or immune globulin
- DO NOT refer persons exposed to measles, or suspected of having measles, to any medical facility WITHOUT calling and making arrangements first. Special arrangements must be made for evaluation and/or measles testing to protect other patients and medical staff from possible infection.
- Measles is an IMMEDIATELY reportable condition and providers should immediately report suspected cases of measles to local public health authorities 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.
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 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.