Raleigh, NC — As measles cases and exposures continue to be reported across North Carolina, a quiet but critical part of the state’s response is happening in the heart of Wake County.
Scientists at the State Laboratory of Public Health in Raleigh are confirming some of the state’s first measles cases in years. Health officials say the work directly impacts how the public is notified, protected, and treated.
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North Carolina has seen at least 23 measles cases since December 2025. Samples in more than a dozen of those cases were sent to the NCDHHS lab.
Laboratory Director Dr. Scott Shone told WRAL News that many of the state’s earliest cases, including some of the highest-risk ones, have come through the lab’s doors.
“The way it works is right now if a provider suspects someone with measles, they can reach out to the epidemiology section of the division of public health and consult with our experts to see if an individual might actually have been exposed to measles and needs testing,” Shone explained. “Epidemiology has a risk score that they apply to each case, and if it is high risk, that sample is brought here because we have a very rapid turnaround time.”
Shone said samples can be sent to the lab within a few hours in some cases.
“The timely need for a measles test result is really dependent on getting to those who might have been exposed to the person,” Shone stated.
That urgency matters because measles exposure can trigger time-sensitive interventions. Unvaccinated people exposed to the virus may be eligible for vaccination within 72 hours, or antibody treatment within six days, depending on their risk.
Measles is one of the most contagious viruses known to humans. Virus particles from one infected person can remain in the air for hours after the individual leaves a room.
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Once a sample reaches the lab, it moves through a tightly controlled process designed to protect both the specimen and staff.
Inside biosafety cabinets, technicians handle respiratory swabs — and, in some cases, urine samples — breaking open the virus to release its genetic material. That material is then isolated and analyzed using PCR technology to determine whether measles is present.
The lab validated urine testing for measles last year, adding another tool to its response.
Each step happens in separate rooms designed to prevent contamination, with strict airflow controls and one-direction movement through the lab.
The lab’s equipment allows it to process dozens of samples at once, including specialized ‘bio robots’ which can isolate genetic material from 96 samples at a time. Shone says the capability to scale is essential given how contagious measles can be.
“Some of our neighboring states and other states across the country have gotten dozens to hundreds of cases in a pretty short order, so we need to be able to scale up our response appropriately,” Shone noted.
The laboratory director explained that preparing for a greater volume of potential cases not only requires additional equipment – some of which is currently being brought online in newly renovated lab spaces – but also cross-training staff on measles-specific testing should more personnel be needed.
“Whether it’s herpes virus, chickenpox, flu, COVID, measles – this team responds to that,” Shone said about the lab’s molecular virology team. “We realized if this does get bigger, we need more people to be part of that rotation. We can’t burn out the response who are responding to all those other viruses because of this one.”
Shone continued, “The lesson we learned from the pandemic, and something that we've really been cognizant of monitoring, is that it is a lot easier to prepare for these during peacetime than when you're in the middle of the war against these viruses.”
When the state lab confirms a measles case, the work doesn’t stop there. Positive samples are sent to the Centers for Disease Control and Prevention in Atlanta for genetic sequencing.
Shone explained that the process helps health officials determine whether cases in different areas are linked to one another, or if the virus is changing.
State laboratories like the NCDHHS’ facility in Raleigh play a crucial role in maintaining the country’s measles elimination status. The U.S. has held the designation since 2000, though recent surges in cases have put the status in jeopardy.
“With every measles case we continue to see, it puts that designation at risk,” Shone said. “Sequencing helps us understand whether cases are linked or if there are new introductions, and that information guides the public health response.”
Health officials continue to emphasize that vaccination remains the most effective way to prevent measles. Two doses of the MMR vaccine provide 97% lifetime protection, according to the CDC.
The disease has no cure and is particularly dangerous for young children. Severe cases can require hospitalization and lead to encephalitis or brain swelling and pneumonia.
The vaccine is recommended for children 12 months and older. However, NCDHHS is now urging families in areas with ongoing outbreaks to talk to their pediatricians about earlier vaccination.
