Gov. Kathy Hochul has declared a disaster emergency in response to the spread of measles across rural parts of New York state and neighboring Pennsylvania.

Dr. James McDonald, the state health commissioner, discussed the disaster declaration and what’s driving it, with All Things Considered host Sean Carlson.

Here’s a transcript of their conversation, edited for length and clarity:

What it means right now is we now have additional authority granted to us by the governor. We have 110 cases of measles so far in New York state. That's more than twice what we had all of last year. The executive order gives us new tools. One tool is, more healthcare workers can administer the vaccine: EMTs, paramedics, pharmacists, community midwives, all trusted people in the community. That helps us.

Another tool we have in the executive order is, we can have more testing done, so nurses can do standing orders and have testing for measles. That helps us find cases quicker, and that will help us identify more cases of measles. The third thing it does is, we get immunization information on adults in our data registry so we know what communities have had the vaccine. That'll help us better plan for where we're likely to see more outbreaks.

It’s rural New York, and really what we're seeing is, there's a lot of local spread in rural New York.

Now, keep in mind, what I mean by that is, it's the most contagious disease out there. So what you see is people come home, and then they spread it to their family, and it spreads really quickly. If your family's not immunized, you're almost all going to get infected. When I say it's the most contagious disease, it doesn't have to be this way. Measles is preventable, almost 100% preventable.

The measles, mumps and rubella vaccine — the one that's been around since 1971 — it's the only way to prevent measles, and it really is our best tool in the toolbox. We have to get more people immunized as quickly as possible, so we can really achieve community immunity. We need to get back to that.

One of the things I wanted to underscore nationally is, what's been going on the last two years in the United States is not normal. When you look at the data for 2025, we had almost 2,400 cases of measles in the United States. This year we have almost 3,700 cases and climbing. This is not normal.

What you've been seeing for the prior 25 years was we would average under 100 cases a year, and I don't want us to be desensitized to that. We should not be tolerating thousands of cases as a country every year of a vaccine-preventable disease.

One of the things about measles, it starts out looking like a cough, runny nose, your eyes get watery, maybe a little bit red, and then you get the rash a few days into it, and you might get spots inside your throat. Where it gets really serious is when people get pneumonia. People do end up with respiratory failure. They can end up on breathing machines. About 1 in 5 people we know about with measles are ending up in a hospital.

It is not a mild childhood illness. It is a serious disease. And one of the things that's unusual about the outbreak we're seeing right now is, two out of three cases are in adults.

And one of the things that's important to remember is New York has really good vaccine requirements , but they're school-entry requirements, so if you're an adult between 18 and 69, you really need to have made sure you've had two measles, mumps and rubella vaccines in your life. If you don't know that, contact your local health department or your doctor's office and get a measles, mumps and rubella vaccine. It's just that simple.

If you haven't had two measles, mumps and rubella vaccines, you need to be concerned because the vaccine doesn't respect borders. One of the things about measles people need to remember is, people are very contagious four days before they start having symptoms. So they don't even know they're going to have measles, but that's when they're very contagious, and they're contagious four days after their symptoms start, which can be kind of mild.

And this is really the main point: You can't tell that you're being exposed all the time.