Kootenai health officials ‘very concerned’ for potential outbreak after child tests positive for measles

An unvaccinated child in Kootenai County has tested positive for measles.

The first case of measles in the county since 1991, it remains unclear if the case will spread. According to Idaho Division of Public Health Medical Director Christine Hahn, the child likely contracted the disease in Kootenai County – meaning there are likely other cases that have gone unreported.

“We believe there may be other people in the area with measles that haven’t been tested yet or diagnosed yet. We want people to know that measles is here,” she said.

On Wednesday, regular monitoring found measles in Coeur d’Alene wastewater, which means measles is likely already circulating within the community, according to Hahn.

The Kootenai County resident is the third measles case in Idaho this year, but the others were international travelers who contracted the viral infection abroad.

“In this case, we don’t have a history of travel. We don’t have a known exposure to anybody who had measles or measles symptoms,” Hahn said. “That is especially concerning because that means there was probably someone else in the community that had measles and unknowingly spread it. Maybe they never realized because they didn’t get that sick and they never got tested.”

Measles often presents with a high fever, runny nose and a cough. But it is distinguished by a rash that appears three to five days after initial symptoms – starting on the face and then moving down the body. The disease is so infectious because someone can spread it for more than a week before they exhibit symptoms, and the virus can stay in the air for two hours after an infected person has left a room.

Symptoms typically appear seven to 14 days after exposure. The infectious period for the Kootenai County adolescent ended Tuesday, and there were “multiple potential exposures” during that period, Hahn said. Should they have infected anyone else, symptoms should appear sometime in the next week.

Hahn is “concerned” this case might be the beginning of a larger outbreak in Kootenai County. A measles outbreak in Texas has continued for much of this year, with more than 800 cases in the state so far in 2025. Two unvaccinated children and one adult have died from measles in the United States so far this year.

“We do worry this could become part of an outbreak. This virus is so infectious, so we are very concerned,” she said.

An outbreak could be exacerbated by the return to schools next month when children congregate inside.

Idaho has the nation’s lowest MMR vaccination rate, which protects against measles, mumps and rubella, according to U.S. Centers for Disease Control and Prevention data. In the 2023-2024 school year, only 79% of Idaho kindergartners were fully vaccinated against measles, compared to 92.5% in the country as a whole. More than 95% of kindergarten-age children need to have two doses of the measles-mumps-rubella vaccine to prevent a measles outbreak, according to the CDC.

The Idaho Department of Health is asking parents to vaccinate their children before school starts this fall.

“We are urging parents to reconsider if they were more worried about the vaccine than the disease. The disease is here now, and it can be very serious,” Hahn said.

Among school districts in Spokane County, 86.4% of kindergartners were fully vaccinated against measles in the 2023-2024 year.

The positive case also “does present risk of transmission to Spokane County” because of the “continuous connectivity between” Spokane and Coeur d’Alene, Spokane Regional Health District spokesperson Kelli Hawkins said in a statement.

“SRHD’s Disease, Prevention, and Response team is in communication with Idaho Panhandle Health and being kept updated on the details for this case. We have sent a provider alert to health care providers in Spokane County to increase awareness of the risk as they are treating patients. SRHD is hosting a community vaccination clinic on Aug. 27, 3-6 p.m. at Shaw Middle School,” Hawkins said.

Last year, there was a measles outbreak in Deer Park, but it was contained to one household and three cases.

If a person thinks they were exposed to measles, or is experiencing symptoms, call ahead to the clinic or health care provider so measures can be taken to protect others.