In 2000, it was declared eradicated in the United States. It has since re-emerged, in large part due to a combination of the rise of the anti-vaccine movement and imported cases (from other countries with lower vaccination rates). Since Jan. 1, 2019, there have been 159 confirmed cases of measles in 10 states: California, Colorado, Connecticut, Georgia, Illinois, New Jersey, New York, Oregon, Texas and Washington. For comparison, in 2018 there were 63 new cases of measles in the US for the entire year. Some areas have had to declare a state of emergency. Early identification in the ED is critical to minimize exposure and help prevent spread.