North Dakota health officials warned Thursday about possible community spread of measles after a case was identified in Pembina County.

The state’s second case of the disease for 2026 involves an unvaccinated adult who was required to be hospitalized, according to the Department of Health and Human Services. The person had not traveled and likely was exposed in North Dakota, though officials were still working to determine the source.

The case in far northeastern North Dakota is not connected to the first North Dakota measles case of 2026, reported in Williams County in the northwest part of the state last week. That case also involved an unvaccinated adult, but that infection was linked to out-of-state travel.

For the Pembina County case, health officials are identifying and notifying people who may have been exposed.

“When measles appears in a community without a travel link, it signals that the virus may be spreading more broadly,” said Molly Howell, director of HHS disease control and forensic pathology, in a statement.

North Dakota HHS released a list of exposure sites related to the Pembina County measles case. Those exposure sites are:

• Charras and Tequila Mexican Cuisine in Grand Forks, on Feb. 4, between noon and 3 p.m.
• Cavalier Public School gymnasium on Feb. 4, between 3:45 and 7 p.m.
• Cavalier Clinic Care waiting room on Feb. 6 between 8:30 and 11 a.m.

People who were at those sites should monitor themselves for symptoms and contact a health care provider if symptoms develop.

Measles symptoms often include fever, cough, runny nose and eye irritation, followed by a widespread rash, according to the department.

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A person who thinks they may have contracted the disease should call a health care provider before going to a medical clinic for treatment to avoid spreading the disease to others. If the person is unvaccinated, they should quarantine themselves for 21 days after the date of the exposure, the department said.

Due to the potential community spread in the Pembina County measles case, the department recommends any residents and travelers to Pembina County should ensure they are vaccinated against measles.

The department recommends parents of infants 6 to 11 months old consider having the child receive an early dose of the MMR vaccine. Also, any child 12 months of age or older should receive their first dose of the MMR vaccine and a second dose 28 days later.

“The most effective protection we have is vaccination,” Howell said. “When individuals are immunized against measles, they protect themselves and also infants and others who may be more vulnerable to severe illness.”

North Dakotans can review their vaccination records through the HHS website.

In 2025, North Dakota reported 36 measles cases, the first since 2011.

The department also said measles is a highly contagious viral illness that can be serious, particularly for young children and individuals with compromised immune systems. Measles spreads easily through the air and can remain in a room and on surfaces for up to two hours after a contagious person leaves the space.

For more information on measles, and for updated data on the status of the disease in North Dakota, visit the HHS measles dashboard.