“As of August 24, seventeen confirmed cases of measles have been identified in 2026, with evidence of person-to-person spread,” the Iowa Department of Health and Human Services (Iowa HHS) reported Monday. That’s five more cases than Iowa HHS reported in its last update on the measles outbreak in the state on Aug. 16.
The department announced Iowa’s first case of measles confirmed by laboratory testing on July 8. That case involved a vaccinated adult who had recently returned from international travel, during which the disease was contracted. The subsequent 16 confirmed cases reported by Iowa HHS do not involve international travel, but have been attributed to person-to-person transmission.
The number of Iowa’s confirmed cases has already exceeded last year’s total of nine.
“These numbers are a departure from recent history,” Linn County Public Health (LCPH) explained in a blog post. “Before last year, there had not been measles in Iowa since 2019, but even those cases were a rarity. Measles had not really been present in the U.S. since the 1990s. Measles was declared officially eliminated from the U.S. in 2000, meaning it wasn’t spreading in the country and the only new cases were from people traveling abroad and bringing it home.”
“Measles cases in the U.S. and Iowa are ticking back up due to decreased vaccination. Iowa HHS shared information showing how vaccination exemptions in the state have increased in the last 20 years.”
Symptoms of measles include fever, cough, watery eyes, runny nose, tiny white spots in the mouth and a rash that spreads from the head downward. It can take 14 days for symptoms to manifest, and an infected person can spread the disease four days before the telltale rash appears.
In its new update, Iowa HHS lists nine locations in Des Moines, West Des Moines, Clive and Bloomfield where infected individuals are known to have been while contagious.
There were 2,289 confirmed cases of measles nationwide in 2025. There were three deaths from the disease, one adult and two school-age children. They were the first measles deaths recorded in a decade.
So far this year, there have been 2,813 confirmed cases of measles reported nationwide, the highest number since 1991. On Tuesday morning, the Pennsylvania Department of Health reported the first measles deaths of the year. The department identified the two deceased only as unvaccinated individuals from Lancaster County. These are the first deaths from measles in Pennsylvania in 35 years.
“Because measles was largely eliminated in the Commonwealth for more than three decades, people are not familiar with this disease and don’t fully understand the potential severity of the illness,” Dr. Debra Bogen, Pennsylvania’s health secretary, said in a statement
“Some people think of measles as just a little rash and fever that clear up in a few days,” the CDC says on its site. “But measles can cause serious health complications, especially in children younger than 5 years old.”
As many as 20 percent of children infected with measles develop pneumonia, which is the leading cause of childhood deaths from the disease. In rare cases, children can also experience brain swelling, which can result in lifelong disabilities.
There are currently no treatments for measles, although doctors can help manage symptoms. That’s why public health authorities stress the importance of immunization against the disease, with two doses of the MMR (measles, mumps and rubella) vaccine for children. The standard recommendation, endorsed by the CDC and other public health authorities, is for a child to have the first dose when they are between 12 and 15 months, and the second dose before the child is 4 or starts school.
A vaccination rate of greater than 95 percent is needed before unvaccinated people are protected against the spread of measles through community, or herd, immunity. According to data from the CDC, in the 2025-26 school year, only 92.5 percent of kindergarteners nationwide had been vaccinated against measles. At the state-level in Iowa, that number drops to 88.9 percent.
“The numbers are clear,” LCPH said in its post. “When vaccination rates go down, measles cases go up.”
Disinformation about safe and effective vaccines like the MMR shot has been a major factor in depressing vaccination rates. Some of that disinformation comes for the president himself.
On Aug. 10, President Trump signed an executive order on vaccines that, among other things, directs that the MMR vaccine be divided into three separate vaccines, one for each disease, to be administered on different occasions.
“Together there could be a possibility they are quite lethal,” Trump said at a signing ceremony for the order. “Separately it looks like they are not at all lethal, but just very effective.”
That is absolutely false, as are the president’s repeated claims that there is a link between childhood vaccinations and autism.
The executive order does not have the force of law, and will not change the recommendations from public health experts on the MMR vaccine.
“There’s no country on Earth that does that,” Dr. Joshua Sharfstein, vice dean for public health practice and community engagement and distinguished professor of the practice in Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health, said in his analysis of the executive order.“It’s not even possible because those vaccines aren’t typically made in the quantities to be able to do that. There’s no study that backs it.”
“It came from an assertion that was made more than 25 years ago by the author of a paper published in The Lancet that was retracted because it was scientifically invalid,” Sharfstein told the Public Health On Call podcast. “That author had a patent on a competing product that would benefit from the paper’s recommendations. Twenty-five years later, not a single reputable scientific organization supports separating the MMR vaccine. With this executive order, it is now the policy of the United States to try to make it happen.”
Sharfstein noted that the president signed his order, and dispensed his disinformation, as the country is “currently experiencing the biggest measles outbreak in decades. Later this year, the U.S. will likely lose our status as a country that’s eliminated transmission of measles.”
