Measles outbreak in North Dakota prompts local health officials to quarantine unvaccinated schoolchildren

By Deidre McPhillips, CNN

(CNN) — Measles cases continue to accumulate in the United States in what is already the second-worst year since the disease was declared eliminated a quarter-century ago. Now, a recent outbreak in one North Dakota county has led local health officials to quarantine nearly 200 unvaccinated students.

North Dakota has reported nine measles cases this year, and a recent outbreak among schoolchildren in Williams County in the northwest part of the state has led local health officials to enforce a law that requires unvaccinated students to quarantine for 21 days after exposure to someone who has the virus. The move was taken by local public health officers in the Upper Missouri District Health Unit, and the state health department is assisting with mitigation efforts.

On Tuesday, families of 188 unvaccinated students in the Williston Basin School District No. 7 received a letter informing them that their children would need to quarantine for three weeks.

About two weeks earlier, district nurse coordinator Lynn Douglas had sent a letter to all families in anticipation of an outbreak, preemptively outlining the quarantine procedure and highlighting the importance of prevention, including vaccination.

“Williston Basin School District #7 plays a very important role in the health and well-being of our students,” Douglas said in an email to CNN. “Having vaccine-preventable diseases circulating within a school would lead to large numbers of school absences and adversely affect the health of our students.”

“While even a small drop in immunization rates can lead to outbreaks, unvaccinated students are at significant risk of serious illness and complications from measles, which are highly contagious and preventable diseases,” she said. “WBSD #7 prioritizes student safety by taking measures to protect unvaccinated students and prevent the spread of illness to themselves, their families, and others and in order to do this, students must be excluded.”

There have been at least 1,018 measles cases reported in the US in 2025, according to a CNN tally using data from state health departments and the US Centers for Disease Control and Prevention. The CDC publishes data on measles cases each Friday, but it has stopped providing details on the specific number of cases in each state, and its national total does not always capture the latest updates from states.

The vast majority of these cases – at least 845 – are associated with an outbreak centered in West Texas that has expanded to New Mexico, Oklahoma and possibly Kansas. Texas has reported 709 outbreak-associated cases, New Mexico reported 71 cases, and Oklahoma reported 17 cases – 14 confirmed and three probable – as of Friday. Cases in Kansas, which the state health department says may be linked to the outbreak, have reached 48 as of Wednesday. Experts say these numbers are all a severe undercount because many cases are going unreported.

Since measles was declared eliminated in the US in 2000, 2019 is only other year in which there were more than 1,000 cases, driven by large outbreaks in New York City and a nearby suburb. There were 1,274 confirmed measles cases that year, according to the CDC, only about 250 more than have been reported so far in 2025.

Nationwide, CDC data shows that 126 people have been hospitalized with measles this year – about 13% of all cases – and there have been three confirmed deaths associated with the large multistate outbreak: two children in Texas and one adult in New Mexico, all of whom were unvaccinated. The vast majority of cases in the US this year have been in people who are unvaccinated; only about 4% of confirmed cases have been in people who had received one or two doses of the measles-mumps-rubella (MMR) vaccine, according to the CDC.

There have been 14 total outbreaks this year, and 30 states have reported at least one case, according to the CDC.

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