By Sabine Martin, Michaela Ramm, Des Moines Register
An unvaccinated adult in central Iowa has tested positive for measles, marking the first confirmed case of the highly contagious respiratory virus in the state since 2019, the state Department of Health and Human Services said.
Iowa HHS wrote in a release Friday, May 23, that the person’s case tested positive through the State Hygienic Laboratory. The state hasn’t released the identity of the person who tested positive, nor where they are from.
No widespread public exposure is expected through the case, and an investigation has been completed.
Iowa is among 31 states that have confirmed measles cases involved in a growing nationwide outbreak that has totaled 1,046 cases, including three deaths because of the illness this year, according to Centers for Disease Control and Prevention data as of May 22.
State Medical Director Robert Kruse said in the May 23 release that the best tool to prevent measles is the measles, mumps, and rubella (MMR) vaccine.
Once thought to be mostly eliminated in the US, there are over 220 measles cases across 12 states with two deaths reported in 2025.
“Getting vaccinated not only protects you but also protects people in your community who can’t get vaccinated, like infants too young to begin the series and those who are immunosuppressed,” Kruse said. “We ask Iowans to review their vaccination records and medical records to ensure they are protected and to reach out to their healthcare provider if they have questions.”
There have been no measles cases reported in the state since 2019, according to state public health officials. A major outbreak occurred that year, resulting in measles cases nationwide.
Iowa has had sporadic measles cases over the years but has avoided major outbreaks in recent memory.
However, growing vaccine hesitancy nationwide has helped contribute to a dramatically changing landscape for states. The World Health Organization declared measles eliminated in the United States in 2000, but in the years since, the disease has reemerged nationwide with more frequency in recent years.
What are the symptoms for measles?
According to the Mayo Clinic, measles symptoms show up around one to two weeks after someone is in contact with the virus.
Initial symptoms include:
- Fever (reaching up to 105 degrees)
- Dry cough
- Runny nose
- Red, watering eyes
About two to three days after the first symptoms, tiny white spots (Koplik spots) might appear inside the infected person’s mouth.
Roughly three to five days after the first symptoms, a rash likely will appear, comprised of large, flat spots and small raised bumps starting on the face or neck and spreads down the body.
Someone with measles can spread the virus four days before and after a rash appears.
Why are health officials alarmed about measles?
Measles is an illness caused by a respiratory virus, and its symptoms include a widespread rash, fever and other flu-like symptoms.
It’s also highly contagious. Droplets from an infected person coughing or sneezing can stay airborne and live on surfaces for hours, which means one infected person can infect up to 10 others if they are not protected against the virus, according to the CDC.
It’s estimated up to 90% of people who haven’t had measles or have never been vaccinated will become infected when exposed to the disease.
The current measles outbreaks in the United States have an overall hospitalization rate of 17%, with the vast majority of those patients including unvaccinated children, according to the World Health Organization.
Should children be vaccinated against measles?
Local health experts say the measles, mumps and rubella (MMR) vaccine is the most effective way to prevent serious illness and death from an infection.
One dose of the MMR vaccine is 93% effective against measles, and two doses are 97% effective, per the CDC.
It’s recommended children get the first dose of the MMR vaccine between the ages of 12 to 15 months old, and the second between 4 to 6 years old. Most individuals do not need a booster or additional dose of the vaccine to be protected from the disease.
Local health experts are encouraging parents and guardians to make sure their child is up-to-date on all of their childhood immunizations, including MMR. They’re also encouraging adults to check their vaccine records to make sure they’re also up-to-date on all of their shots.
A population needs to reach at least a 94% vaccination rate to achieve herd immunity against measles, which means enough people in a population are immune to a disease and make it difficult for it to spread, according to health officials.
Without it, Juliann Van Liew, director of the Polk County Health Department, previously told the Register that measles can become endemic, meaning a disease can regularly occur in a community or area.
What is happening with vaccination rates in Iowa?
Current vaccination estimates in Iowa show immunization rates among young Iowans — who would be most at risk for an infection — have not reached the level necessary to achieve that protection.
In 2024, 84% of 2-year-olds and nearly 86% of adolescents between the ages of 13 and 15 had completed the two-dose MMR vaccine series, according to state public health data.
The CDC estimates approximately 89% of kindergartners in Iowa were fully vaccinated against measles during the 2023-24 school year.
Van Liew said Polk County has seen consistent declines of fully vaccinated school-aged children since 2018.
School immunization reports for the 2023-24 school year show about 6% of all students in Polk County, or about 5,500 students, were not fully vaccinated. That’s compared with 2,600 students in the 2018-19 school year.
Van Liew said the county has seen those rates increase in nonpublic schools, where about 88% of students are fully vaccinated.
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