A disease declared eliminated from the United States a quarter-century ago is now filling pediatric wards at rates not seen since the early 1990s — and the clinical workforce managing these cases needs updated guidance on a pathogen many trained nurses have never encountered in practice. That gap between institutional memory and bedside readiness is the central problem this review addresses.
Reported measles cases surpassed 2,200 across 48 separate outbreaks in 2025 alone — the highest single-year burden since 1992. The first half of 2026 added another 2,073 cases, suggesting the resurgence is accelerating rather than stabilizing. The disease's epidemiology traces directly to declining MMR vaccination coverage, which has expanded the pool of susceptible children. Clinically, measles presents with a recognizable prodrome — fever, cough, coryza, and conjunctivitis — before the characteristic morbilliform rash, but it is the complications that drive ICU admission: severe respiratory compromise and neurological involvement including encephalitis, which may manifest weeks to years after the acute infection. Treatment remains supportive, with vitamin A supplementation for high-risk pediatric patients representing the principal evidence-based adjunct.
This review is clinically significant because it addresses a competency deficit created by decades of successful elimination. Critical care nurses entering practice after 2000 have had virtually no experiential exposure to measles management, airborne isolation protocols for this pathogen, or the recognition of subacute sclerosing panencephalitis — a rare but fatal late neurological complication. The review draws from a broad evidence base, though it is inherently a narrative synthesis rather than a systematic review or meta-analysis, which limits its ability to resolve clinical uncertainty quantitatively. Its value lies in consolidating preparedness guidance at a moment when health systems are underprepared. The resurgence represents a direct, measurable consequence of vaccine hesitancy — making this not just a nursing education issue, but a public health inflection point.