This analysis aims to describe the challenges encountered and lessons learned during the Multnomah County Health Department’s response to this measles outbreak in a childcare facility setting, distilled through qualitative interviews with health department staff involved in the response. Although this outbreak was small, these challenges and lessons learned may inform public health policy and help other local public health authorities prepare for measles outbreaks. These lessons will become increasingly important as measles cases continue to increase in both the US and abroad. (author abstract)