The Hawaiʻi Department of Health (DOH) is monitoring the first positive detection of measles virus in wastewater from Kauaʻi County. The sample, collected on September 24, 2025, at a site in East Kauaʻi County, was confirmed positive on October 20, 2025. According to the DOH, there have been no suspected measles cases identified on Kauaʻi at this time.
Municipal wastewater samples from across Hawaiʻi are sent weekly to the University of Missouri for deep sequencing to identify genetic material from bacteria and viruses that may indicate community infections. Recent analysis found the presence of the measles virus genotype D8 sequence in a sample from Kauaʻi County. Genotype D is associated with wild measles virus, while vaccines use genotype A. The DOH expects additional sequencing results by the end of this week.
Wastewater sampling is a routine part of infectious disease surveillance in Hawaiʻi. This method can detect viral genomic material shed by infected individuals even if they do not show symptoms or have not reported illness. The detection of measles virus in wastewater does not confirm a clinical case or community spread but serves as an indicator for possible cases.
The State Laboratories Division (SLD) will continue monitoring and testing wastewater samples to support early detection and public health preparedness. Measles is also being tracked in wastewater by national programs such as the National Wastewater Surveillance System (NWSS) and WastewaterSCAN.
The DOH encourages residents to stay current with the measles, mumps and rubella (MMR) vaccine. Measles is highly contagious but can be prevented through vaccination. Infants under one year old are especially vulnerable because they are generally too young for vaccination; however, vaccination may be recommended for children between six and twelve months if they are exposed to a known case. Individuals seeking an MMR vaccine should contact their medical provider or pharmacy.
People who have traveled to areas experiencing current measles outbreaks should consult their doctor if they develop symptoms. As of October 21, 2025, 42 states in the U.S. have reported measles cases. The DOH will issue a medical advisory to healthcare providers statewide with guidance on testing for measles and current vaccination recommendations.
Measles symptoms typically begin with a high fever, cough, runny nose and red eyes, followed by a rash that starts at the head and spreads downward. Complications can include pneumonia, neurological illness and death.
Anyone who suspects they have symptoms of measles or were exposed to someone with measles is advised to isolate immediately and contact their healthcare provider for further instructions.
The SLD’s wastewater testing program collaborates with the University of Missouri laboratory as part of a project aimed at improving detection of infectious disease pathogens in the environment nationwide. This effort seeks to strengthen environmental monitoring to help detect and contain outbreaks and other biological threats by analyzing samples from various sites across the country.
For more information about measles and related resources, visit:
– DOH measles information website
– CDC measles website
– MMR vaccine factsheet
– Wastewater Data for Measles | National Wastewater Surveillance System | CDC
– WastewaterSCAN Dashboard
