North Dakota has joined the growing list of U.S. states facing active measles outbreaks, marking the 11th state with sustained transmission, according to the Associated Press. State health officials have confirmed nine cases of measles in Williams County, located in western North Dakota. 

The North Dakota Department of Health and Human Services reported that three of the confirmed cases are connected to the state's index case—an unvaccinated child believed to have contracted the virus from an out-of-state visitor.

However, five cases involved unvaccinated individuals who had no known contact with the others, raising red flags about potential community transmission.  The outbreak comes amid a nationwide surge in measles infections. The U.S. Centers for Disease Control and Prevention (CDC) reports 935 cases so far in 2025—more than triple the total number recorded in all of 2024.

The majority of infections have occurred in children: 30% in those under age 5 and 38% in individuals aged 5 to 19. At least 121 people have been hospitalized, and three deaths have been confirmed.  A staggering 96% of reported cases were in individuals who were either unvaccinated or had an unknown vaccination status.

Only 4% had received one or two doses of the measles-mumps-rubella (MMR) vaccine.  Texas remains the hardest-hit state, with 702 confirmed cases over the past three months. Other states with active outbreaks—defined by three or more related cases—include Kansas (48 cases), New Mexico (67 cases), Indiana, Michigan, Montana, Ohio, Oklahoma, Pennsylvania, and Tennessee. 

Meanwhile, isolated cases have also been reported in numerous other states, including Alaska, California, Florida, Illinois, New York, and Washington, among others.  Health experts continue to stress the importance of routine childhood vaccinations to curb the spread of the highly contagious virus.

With measles capable of leading to serious complications such as pneumonia, brain swelling, and even death, public health officials are urging communities to bolster immunization efforts.