North Dakota up to 6 measles cases, with jump in exposure sites in eastern counties

BISMARCK, N.D. (North Dakota Monitor) — North Dakota had six confirmed measles cases Monday and a growing list of potential exposure sites in the eastern portion of the state, the Department of Health and Human Services said.

Pembina County reported five measles cases; three are adults, one is a child under age 5 and one is between 5 and 19 years old.

The department added to its list of potential exposure sites, listing 23 locations in Cavalier, Colfax, Grand Forks, Fargo and Walhalla where people may have been exposed to the disease from Feb. 4-11.

“I do think we’re going to see additional cases,” Molly Howell, director of disease control and forensic pathology for HHS, said in an interview.

Williams County in northwest North Dakota has one confirmed case of measles this year involving an unvaccinated adult who contracted the disease while traveling out of state, the department has said.

People who were at possible exposure sites should monitor for symptoms of the disease, according to the department. Unvaccinated people born after 1957 who were at those sites during the times listed should quarantine for 21 days to prevent spreading the disease, the department said. People with at least one dose of the measles, mumps and rubella vaccine do not need to quarantine, but should still monitor for symptoms, state health officials advise.

Measles symptoms often include fever, cough, runny nose and eye irritation, followed by a widespread rash, according to the department. Howell said people can transmit the disease for up to four days before a rash develops.

Howell said she worries people think that measles is just a minor disease involving a rash, but complications can lead to serious illnesses, such as pneumonia and brain swelling.

“We’ve already had at least one individual that has been hospitalized with measles,” she said. “We do want people to take it seriously, but at the same time, we have a vaccine that works really well.”

Measles is also much more contagious than the flu, she said. An infected person can typically spread influenza to one or two people, but one person infected with measles can spread it to 18 other people, she said.

Due to the potential community spread in the Pembina County measles cases, the department recommends any residents and travelers to Pembina County should ensure they are vaccinated against measles. Parents of small children in Pembina County should consider vaccinating them at 6 months, instead of starting their vaccines at 1 year old, according to HHS.

If an exposed person develops symptoms of the disease, they should notify a health care provider before seeking treatment at a medical clinic to ensure special arrangements are made to prevent exposure to other patients and medical staff.

Altru Health System in Grand Forks recommends people experiencing symptoms should call the 24/7 Altru nurse advice line at 701-780-6358 before arriving at any clinic.

“We want to avoid spreading measles in waiting rooms, or emergency rooms, or urgent care and places like that,” Howell said.

Four of the six measles cases in North Dakota in 2026 involved people who were unvaccinated and two cases occurred in people who were fully vaccinated, according to the department dashboard.

“If people who are vaccinated have two doses of the MMR vaccine, the vaccine is 97% effective,” Howell said. “That’s not 100%, but it is a highly effective vaccine.”

The U.S. Centers for Disease Control and Prevention confirmed 910 measles cases across 24 states this year, as of Feb. 13. In those cases, 94% occurred in people who were unvaccinated, according to the CDC.

The national health agency said 2,280 measles cases were confirmed across 44 states in 2025.

North Dakota last year reported 36 measles cases across Williams, Grand Forks, Cass and Burke counties. Williams County reported 18 measles cases, followed by Grand Forks County with 10 and Cass County with 7 reported cases.

Howell said people looking for more information on measles, or the measles vaccine, in North Dakota should visit the department’s measles dashboard, or contact a trusted health care provider in their area.

North Dakota Monitor reporter Michael Achterling can be reached at machterling@northdakotamonitor.com.

A list of measles exposure locations is listed here.