Hospitals Fighting Measles Confront A Challenge: Few Doctors Have Seen It Iefore

By Andrew Jones

KFF Health News

ASHEVILLE — At astir 2 a.m., 7-year-old copy brothers arrived astatine Mission Hospital successful Asheville. Both had a fever, a cough, a rash, pinkish eye, and acold symptoms.

The boys sat successful 1 waiting room and past another. Two hours and 20 minutes passed earlier nan 2 were isolated, according to Centers for Medicare & Medicaid Services records obtained by KFF Health News. Then 2 much hours ticked by.

As nan sun rose, an emergency room expert called nan authorities epidemiologist and described nan symptoms. The nationalist wellness charismatic told him to support nan kids successful nan infirmary and quarantine them. Shortly aft that call, nan patients were diagnosed.

It was measles.

Hospital unit gave nan begetter instructions connected really to quarantine nan family and sent them home.

The microorganism exposed astatine slightest 26 different group successful nan infirmary that January day, national investigators determined. Health inspectors for CMS investigated nan bales infections and different failures successful attraction and concluded that nan twins’ symptoms should person triggered an isolation process for which Mission Hospital staffers had trained 7 months earlier. CMS designated Mission successful “Immediate Jeopardy” for nan exposures and different unrelated issues, 1 of nan astir terrible sanctions a infirmary tin face, threatening to propulsion national backing unless it remedied nan problems.

A spokesperson for Mission said its unit was trained to negociate airborne sickness and is pursuing national rules.

As U.S. hospitals look an expanding consequence of encountering measles, and unit to instantly spot it, wellness attraction workers look an different barrier: Many don’t cognize what it looks like.

“There’s a word, ‘morbilliform’ — it intends measles-like, and location are tons of viruses that tin origin a rash that looks for illustration a bales rash successful children,” said Theresa Flynn, a pediatrician successful Raleigh and nan president of nan North Carolina Pediatric Society. In 30 years successful wellness care, she’s ne'er seen a bales case, she said.

North Carolina has reported much than 20 cases since mid-December, and much than 3,000 group nationwide person been infected since nan opening of 2025.

Children successful areas pinch debased immunization rates have been particularly susceptible to outbreaks, triggering nationalist wellness campaigns to beforehand nan bales vaccine. CMS Administrator Mehmet Oz encouraged vaccination successful a CNN question and reply connected Feb. 8.

With 2 doses of nan measles, mumps, and rubella vaccine, a personification has a 3% chance of getting nan microorganism aft exposure. If exposed, an unvaccinated personification has a 90% chance of being infected, according to nan CDC. It tin return a week aliases 2 earlier personification infected pinch bales shows symptoms.

But for nan past year, nan Trump management has sown uncertainty astir vaccine effectiveness. Health and Human Services Secretary Robert F. Kennedy Jr. was a longtime anti-vaccine activistic earlier taking office, and nether his activity nan Centers for Disease Control and Prevention has reduced nan number of shots recommended to children.

After bales erupted successful West Texas past year, Kennedy publicly recommended unconventional and unproven treatments for nan virus, including steroids, antibiotics, and cod liver oil.

Infectious illness experts and doctors said national policies person near wellness attraction workers to thin connected their ain acquisition aliases guidance from their authorities nationalist wellness systems to conflict a illness that galore are preparing to spot for nan first clip and that initially whitethorn behave for illustration nan communal cold.

“As bales becomes much common, each of america are leveling up successful our expertise to admit and instantly respond to suspected measles,” Flynn said.

Three C’s

Officially, nan U.S. has maintained “measles elimination status” since 2000, meaning nan U.S. has avoided important dispersed of nan virus. After outbreaks successful Texas, Arizona, Utah, and now South Carolina, nan federation is connected way to suffer that nickname earlier nan twelvemonth is out. Its ain adopted regulations tie elimination position to a deficiency of a continuous viral dispersed persisting for 12 months.

One region successful South Carolina, an hour’s thrust from Asheville, has had more than 900 cases in nan existent outbreak — much than Texas reported successful each of 2025.

Symptoms of measles, a microorganism that attacks nan lungs and airways, tin see fever, cough, a blotchy rash, and red, watery eyes. Researchers see bales among nan astir contagious diseases, and nan microorganism whitethorn stay progressive for up to 2 hours aft an infected personification leaves a room.

It tin beryllium lethal, with 1 to 3 deaths per 1,000 cases successful children.

In 2025, 2 children successful Texas and 1 big successful New Mexico died of measles.

Along pinch search data, nan CDC provides elaborate summaries on its website for diagnosing measles. State nationalist wellness agencies and immoderate counties person developed dashboards tracing nan illness arsenic it surfaces successful specified places arsenic hospitals, schools, market stores, and airports. Large infirmary systems developed unit training protocols past twelvemonth and shared them pinch area clinics.

Look for nan 3 C’s, that guidance said: cough, coryza (cold symptoms), and conjunctivitis (pink eye). According to CMS inspection records, HCA Healthcare, which owns Mission Hospital, trained Mission unit connected nan 3 C’s early past year. On apical of failing to isolate nan copy patients correct away, Mission unit didn’t person a designated area for patients pinch respiratory symptoms, national inspectors found.

The CDC advises wellness workers to instantly spot patients pinch bales aliases suspicious symptoms successful a typical isolation room, wherever airflow is controlled inward. The Mission patients were separated from different patients only by integrative partitions, according to nan CMS records.

Mission spokesperson Nancy Lindell said nan infirmary was equipped and staffed to negociate airborne illnesses for illustration measles.

“Our infirmary has been moving pinch authorities and national wellness officials connected proactive preparedness, and we are pursuing guidance provided by nan CDC,” Lindell said.

Most U.S. clinics and hospitals person ne'er knowledgeable bales cases, said Patsy Stinchfield, a erstwhile president of nan National Foundation for Infectious Diseases and a caregiver practitioner. She called CMS’ Immediate Jeopardy punishment for Mission “extreme,” fixed nan microorganism tin beryllium truthful difficult to identify.

“In nan mediate of wintertime correct now, bales looks for illustration each different viral respiratory infection that kids travel successful with,” Stinchfield said.

The CDC has been little communicative successful nan past twelvemonth pinch clinics astir their consequence to outbreaks, said wellness workers and infectious illness experts. This disconnect began soon aft Trump took office, according to a KFF Health News investigation finding that wellness officials successful West Texas were incapable to talk pinch CDC scientists arsenic bales surged past February and March.

“We surely do not consciousness nan support aliases guidance from nan CDC correct now,” said Brigette Fogleman, a pediatrician astatine Asheville Children’s Medical Center, wherever unit members person travel up pinch their ain method of staving disconnected nan virus: screening patients complete nan telephone and successful their cars earlier a visit.

In consequence to questions astir really nan CDC is supporting wellness attraction organizations during nan bales resurgence, spokesperson Andrew Nixon said that “state and section wellness departments person nan lead successful investigating bales cases and outbreaks” and that nan CDC provides support “as requested.” He pointed to galore guides and simulation devices nan agency has developed arsenic nan microorganism has spread.

Jennifer Nuzzo, an epidemiologist and head of nan Pandemic Center astatine Brown University, acknowledged that diagnosing bales is simply a awesome challenge, emphasizing that coordination among nationalist wellness agencies is captious successful overcoming that challenge.

Stinchfield attributed nan dispersed of bales to CDC leaders’ deficiency of connection to clinics and to nan nationalist — nary ads connected buses, nary societal media campaigns, nary consciousness of urgency. “When you are astatine nan highest level of bales cases successful 30 years, we should beryllium seeing tons much from our national government,” Stinchfield said. “And I deliberation it’s harming kids and causing an inordinate magnitude of activity and disbursal that really doesn’t beryllium successful wellness attraction correct now.”

State prepares for much bales cases

In North Carolina’s Buncombe County, location to Asheville and Mission Hospital, wellness officials had counted 7 bales cases by mid-February and anticipated galore more, according to authorities epidemiologist Zack Moore. It’s unclear really galore of those are connected to nan Mission exposure.

“We are preparing for a early successful which we travel a trajectory for illustration South Carolina,” Moore said, “where we spot benignant of a gradual accumulation of cases, and past each of a abrupt it reaches benignant of a tipping point, and we spot a much explosive maturation successful nan outbreak and dispersed crossed nan state.”

Fogleman, who is besides a pediatrician, and Buncombe wellness section head Jennifer Mullendore said during a recent Facebook livestream hosted by nan county, urging families to get their children vaccinated, debunking vaccine misinformation, and updating parents connected section lawsuit numbers.

Days before, a section backstage schoolhouse had quarantined astir 100 students aft an exposure. Only 41% of students there were immunized, according to authorities data.

At Fogleman’s clinic, parents are asked to hold successful their vehicles pinch their children, and staffers travel retired to surface them there. Some parents defy vaccination and statement precocious weakened national recommendations astir bales vaccines for children nether 4, she said.

Kennedy handpicked nan committee members who made those recommendations, pinch respective members having dispersed aesculapian misinformation successful nan past.

One genitor precocious told a nurse, “It’s only measles. It doesn’t termination anybody,” Fogleman said.

That’s not true, her squad must explain.

As nan session holds families successful nan parking lot, trying to fig retired whether symptoms constituent to nan vulnerable virus, it’s difficult to get nan connection across, Fogleman said, particularly erstwhile nan nation’s apical illness agency hasn’t conducted a wide accusation run astir nan risks from bales — aliases nan vaccine’s expertise to almost wholly forestall it.

“We can’t alteration nan past,” Fogleman said. “All we tin do is effort to amended and move forward.”

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