A wastewater sample collected from a site in east Kauaʻi County on Feb. 25 has tested positive for the measles virus, according to the Hawaiʻi Department of Health.
The Department of Health continues to monitor measles statewide and was notified of the result on March 16. Healthcare providers have been notified and are reminded to remain alert for patients who may present with symptoms consistent with measles.
A confirmed measles case was reported in Hawaiʻi on March 7, 2026, involving a visitor who had recently arrived from an area of the continental United States experiencing measles transmission.
The traveler was on Oʻahu and Hawaiʻi Island between Feb. 26 and March 4. Based on the timeline and location, this case does not align with the wastewater detection on Kauaʻi from Feb. 25, 2026.
If you traveled to an area with a current measles outbreak, speak with your doctor if you develop symptoms. International and U.S. locations are still experiencing cases of measles, with 31 states reporting cases as of March 12, 2026.
Measles symptoms usually start with a high fever, cough, runny nose, and red eyes, followed by a rash of tiny red spots that begins at the head and spreads downward. The disease can lead to serious complications, including pneumonia, neurological illness, and death.
For those who may be experiencing symptoms of measles or were exposed to someone with measles, isolate immediately and contact a healthcare provider for guidance to avoid further spread.
The Department of Health urges everyone to stay up to date on the measles, mumps, and rubella vaccine. Measles is highly contagious but preventable through vaccination.
Infants under 1 year of age are at particularly high risk because they are too young to be vaccinated, but in certain situations, vaccination may be recommended for children between 6 and 12 months if they are exposed to a known case.
To get a measles, mumps, and rubella vaccine, contact a medical provider or pharmacy.
Hawaiʻi collects municipal wastewater samples each week and sends them to the State Laboratories Division for digital polymerase chain reaction (dPCR) testing, as well as to the University of Missouri for advanced sequencing to look for bacterial and viral genetic material associated with community infections.
In the most recent results, dPCR testing did not detect measles; however, sequencing identified measles virus D8 in a sample taken from Kauaʻi County on Feb. 25, 2026. Genotype D strains are associated with wild-type measles infections, whereas the vaccine strain is genotype A.
The difference in results is not unusual since dPCR looks for specific targets, while sequencing can detect very small amounts of genetic material. Using both methods provides important redundancy and strengthens Hawaiʻi’s ability to identify low-level signals in wastewater.
A subsequent sample has been collected and will undergo dPCR testing and be shipped for sequencing.
Wastewater sampling is routinely conducted across Hawaiʻi to support infectious disease surveillance. This testing can identify viral genetic material shed by infected individuals, including those who may not yet have symptoms or have not sought medical care.
A measles signal in wastewater does not confirm a clinical case or indicate community transmission. Instead, it serves as an early indicator prompting awareness and monitoring for potential cases.
In addition to the work by State Laboratories Division, measles is also being monitored in other Hawaiʻi counties through the National Wastewater Surveillance System and WastewaterSCAN.
For more information about wastewater surveillance, visit the Hawaiʻi Disease Outbreak Control Division website. For more on measles, visit the Department of Health website.
