Measles Took 5 Children in 8 Days. A Century Later, Their Story Still Matters

It's been said that a visit to a cemetery offers insight into the devastating toll communicable and vaccine-preventable diseases once took on children. For me, I only need to page through my family scrapbook.

My grandmother, Anna, emigrated alone from Germany at age 16, landing in Cleveland, Ohio, before marrying a few years later. Over the next 8 years, they settled in rural Michigan and had 7 children. Then, in early 1926, amid one of the largest measles outbreaks in U.S. history, tragedy struck. Six of their 7 children contracted measles. Sadly, 5 of those children—Esther Marie (6), Walter (4), Margareth (3), Helen (2), and Gertrude (6 months)—died in the span of 8 days, at home or at their local community hospital. Only my Uncle Fred, the oldest at age 9, survived his illness. They were among the 577 measles-related deaths recorded in Michigan and the 8,607 reported across the US that year.¹ Their names remain preserved in photocopied newspaper reports, a reminder of a disease that many people today view as a rare possibility.

Anna was widowed 2 years later, remarried, and eventually gave birth to twins, one of whom was my father. I was born 50 years after she lost 5 children. My grandmother was a quiet yet remarkably strong woman who never spoke about the profound grief she must have carried.

Over the past century, advances in medicine, public health, sanitation, and disease prevention have made stories like my family's seem almost impossible, like the plot in a very sad movie. Yet in 2026, measles remains one of the most contagious infectious diseases known. The rise in cases and declining vaccination rates should be a concerning message to us about a disease that really should have been left in the past.

From “Eliminated” to the Highest Case Counts in Decades

In August 2026, the CDC reported the highest number of measles cases seen in the US since 1991, placing the nation's measles elimination status at risk. At the same time, misinformation continues to circulate about where cases originate, how effective vaccination is, and whether natural immunity is preferable to vaccination.

Where are Measles Cases Coming From?

The CDC reports that MMR vaccination rates have fallen below levels needed to confidently protect communities from measles. While the decline may appear modest, national kindergarten MMR coverage dropped from 95.2% in 2019-2020 to 92.4% in 2025-2026, creating larger pockets of susceptible individuals.²

Of the 3,659 measles cases reported to September 24, 2026, approximately 95% occurred in individuals who were unvaccinated or whose vaccination status was unknown. Hospitalization rates vary by age but average roughly 10% overall. Communities with lower vaccination coverage are particularly vulnerable to rapid transmission. Recent outbreaks affecting hundreds of people, including those in New York City in 2019 and East Texas in 2025, occurred in areas with elevated rates of vaccine exemptions or vaccine hesitancy.^3,4,5

International travel can introduce measles into communities, but it plays a relatively minor role in outbreak activity compared with gaps in vaccination coverage. In many cases, an unvaccinated U.S. resident travels to a country where measles remains common, becomes infected, and returns while still in the incubation period. Because symptoms typically develop 10 to 14 days after exposure, individuals may unknowingly spread the virus through airports, schools, workplaces, healthcare facilities, and social gatherings before realizing they are ill.

The CDC measles cases and outbreaks website provides weekly updates, but state and local health departments often provide the earliest information about outbreak activity within their jurisdictions.⁵

Vaccine Effectiveness

Before the measles vaccine became available, nearly every child contracted measles by age 15. It’s true that measles-related deaths began decreasing even before the vaccine era because of improvements in medical treatments, antibiotics, nutrition, sanitation, and overall access to health care. In 1941, approximately 894,000 measles cases were reported in the United States, the highest annual total on record, with 2,279 associated deaths. While those improvements significantly reduced mortality, complications, including death, still occurred.^6,7

The effectiveness of the MMR vaccine is 97% after 2 doses. Community immunity, often called herd immunity, occurs when enough people are immune to an infectious disease to slow or prevent transmission. This protection is especially important for individuals who cannot be vaccinated, including infants, immunocompromised individuals, and pregnant patients.

When vaccination rates decline, community immunity weakens, increasing the likelihood of outbreaks.

Natural Immunity vs Prevention

Natural immunity refers to protection acquired after infection and recovery. For measles, infection essentially provides lifelong immunity. Some advocates of natural immunity argue that this protection is superior to vaccine-induced immunity and that there are concerns about vaccine risk.

The question, however, is not whether measles infection produces immunity – it absolutely does. It’s about whether the risk of measles is worth it when a safe preventive option exists.

In 2026, approximately 1 in 10 reported measles cases required hospitalization. Serious complications include pneumonia, encephalitis, and, in rare cases, death. Subacute sclerosing panencephalitis (SSPE) is a rare but fatal degenerative neurological condition that can develop years after measles infection. Even in a world of medical advancements and antimicrobials, measles remains the same pathogen as it was a century ago.⁸

Not Just an Infection Prevention and Control Problem

A single case of measles in a health care facility can overwhelm any facility’s infection prevention and control resources. Exposure investigations and tracing, patient notifications, and operational disruptions will consume significant time and resources. An up-to-date plan developed with multidisciplinary input, tabletop exercises to identify process gaps, and communication with leadership are essential.

In addition to maintaining preparedness plans, infection preventionists can play an important role in preventing outbreaks before they occur:

• Be a visible advocate for vaccination. Partner with clinical, occupational/employee health, and community teams to reinforce that vaccination remains the most effective way to prevent measles and protect vulnerable individuals.
• Share clear, consistent information. Provide health care personnel, patients, and families with understandable information about measles risks, vaccine benefits, and what to expect following an exposure. Equip frontline clinicians with evidence-based communication tools.
• Recognize vaccine hesitancy and respond with empathy. Distrust, previous negative health care experiences, social influences, misinformation, and safety concerns can all contribute to hesitancy. Make space for people to share their experiences, and don't assume their perspectives aren't valid.
• Focus on shared values rather than adherence. Conversations about protecting an infant too young to be vaccinated or a patient receiving chemotherapy will be more effective than debates about mandates.
• Stay connected with public health partners. Strong relationships with local health departments, health care organizations, and community leaders help ensure accurate information reaches the people who need it most at the right time. If contact tracing is needed, encourage participation.

I chose to write about my grandmother after reflecting on the fact that an infectious disease affecting our family 100 years ago is once again in the headlines, despite the resources available to prevent it in 2026. With measles once again appearing in communities across the country, we have an opportunity to help ensure that future generations hear these stories from the past, rather than experience them firsthand.

References

1. Mortality Statistics, 1926. US Bureau of the Census. US Government Printing Office; 1929. https://www.cdc.gov/nchs/data/vsushistorical/mortstatsh_1926.pdf
2. Vaccination coverage and exemptions among kindergartners. CDC. SchoolVaxView. Updated August 24, 2026. Accessed September 17, 2026. https://www.cdc.gov/schoolvaxview/data/index.html
3. McDonald R, Ruppert PS, Souto M, et al. Notes from the field: measles outbreaks from imported cases in Orthodox Jewish communities—New York and New Jersey, 2018–2019. MMWR Morb Mortal Wkly Rep. 2019;68:444-445. doi:10.15585/mmwr.mm6819a4
4. Texas announces end of West Texas measles outbreak. Texas Department of State Health Services. Published August 18, 2025. https://www.dshs.texas.gov/news-alerts/texas-announces-end-west-texas-measles-outbreak
5. Zucker JR, Rosen JB, Iwamoto M, et al. Consequences of undervaccination—measles outbreak, New York City, 2018–2019. N Engl J Med. 2020;382(11):1009-1017. doi:10.1056/NEJMoa1912514
6. History of measles. CDC. Updated April 29, 2026. Accessed September 25, 2026. https://www.cdc.gov/measles/about/history.html
7. Measles. Family Practice Notebook. Accessed September 28, 2026. https://mobile.fpnotebook.com/ID/Virus/Msls.htm
8. Measles cases and outbreaks. CDC. Updated September 18, 2026. Accessed September 25, 2026. https://www.cdc.gov/measles/data-research/