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Two new cases of measles were confirmed in North Dakota Friday. That brings the total to

The two new cases are in Traill and Pembina counties, which both border Minnesota. Measles is a highly contagious and vaccine-preventable illness. Last year, North Dakota had 36 confirmed cases of measles. Before that, the last case was in 2011.

The state's vaccination rate for measles, mumps and rubella (MMR) has been declining, according to Molly Howell, the director of disease control and forensic pathology at the North Dakota Health and Human Services department. 

"For the most recent school year, we're actually at about 89 percent of kindergartners up to date for MMR ,” she said. “And although 89 percent sounds really high ... because measles is so contagious, you really need a 95 percent vaccination rate to prevent outbreaks in a community."

Howell said there are many reasons for vaccine hesitancy, including misinformation and a lack of trust in government and public health officials.

“Vaccines tend to be a victim of their own success, so when we don't see vaccine-preventable diseases anymore, we kind of forget about how severe they are, or that they're even there, and so then we kind of get relaxed about vaccinating,” Howell said. 

She added travel may be another reason for the state’s measles outbreak. There have been 

 in the Canadian province of Manitoba in 2026. 

Manitoba borders Pembina County, which is where the vast majority of North Dakota’s measles cases have been.

 lists areas in the state where there may have been public exposure to someone with measles.

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Two cases in Pembina and Traill counties in North Dakota bring the total measles cases to 23 in 2026.

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Measles outbreak in North Dakota up to 23 cases

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