There have now been more measles cases in 2025 than in any other year since the contagious virus was declared eliminated in the United States in 2000, according to new data released Wednesday by the Centers for Disease Control and Prevention.
The grim milestone represents an alarming setback for the country’s public health and heightens concerns that if childhood vaccination rates do not improve, deadly outbreaks of measles — once considered a disease of the past — will become the new normal.
Experts fear that with no clear end to the spread in sight, the country is barreling toward another turning point: losing elimination status, a designation given to countries that have not had continuous spread of measles for more than a year.
“It’s a huge red flag for the direction in which we’re going,” said Dr. William Moss, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health who has studied measles for more than 25 years.
Most of the cases this year have been tied to the Southwest outbreak — the largest single outbreak since 2000 — which began in January in a Mennonite community in West Texas and has since jumped to New Mexico and Oklahoma.
But cases have also popped up in 38 states, which experts say represents a concerning vulnerability to diseases of the past. Because of the contagiousness of the virus, researchers often think of measles as the proverbial canary in a coal mine. It is often the first sign that other vaccine-preventable diseases, like pertussis and Hib meningitis, might soon become more common.
In total, 1,288 people have had a confirmed case of measles this year, 92 percent of whom were unvaccinated or whose vaccination status was unknown.
While measles symptoms typically resolve in a few weeks, the virus can cause pneumonia, making it difficult for patients, especially children, to get oxygen into their lungs. It may also lead to brain swelling, which can cause lasting damage, including blindness, deafness and intellectual disabilities.
For every 1,000 children who get measles, one or two will die, according to the C.D.C. Two unvaccinated children and one adult have died this year, the first such deaths in the country in a decade.
The outbreak’s full effect on public health may not be apparent for years.
The virus causes “immune amnesia,” making the body unable to defend itself against other illnesses it has already been exposed to and leaving patients more susceptible to future infections. And very rarely, the virus can cause a degenerative and almost always deadly neurological condition that may appear a decade after the original infection.
Until now, 2019 held the record for the highest number of measles cases since the virus was eliminated. (Before that, large outbreaks sickened tens of thousands of people in some years.) Most of the 1,274 cases that year were connected to a large outbreak that spread through Orthodox Jewish communities in New York State for nearly 12 months.
With aggressive vaccine mandates, which helped substantially increase childhood immunization rates in the area, the United States only narrowly avoided losing elimination status that year.
Public health experts worry that the country will not be able to avoid that fate this time. Local officials in West Texas have already predicted the outbreak will continue for a year.
While losing elimination status does not necessarily lead to tangible changes, like travel restrictions, it would be a “deeply embarrassing” development for the United States, which should have the technical and financial resources to control the virus, said Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health.
Losing the designation would be “a symbol of how much worse the discourse has gotten, and how politicized vaccines have gotten,” said Dr. Adam Ratner, a pediatric infectious disease expert who recently published a book about the resurgence of measles.
While the country has faced large measles outbreaks in the past, a confluence of factors have made it particularly difficult to rein in the virus this year.
Nationally, the measles vaccination rate fell during the Covid-19 pandemic and has not rebounded to the 95 percent required to stem the spread of the virus in a community. Roughly 93 percent of children in kindergarten in the 2023-24 school year had received the measles, mumps and rubella shot, though rates in some parts of the country were far lower.
In Gaines County, the center of the Texas outbreak, just 82 percent of the population received the M.M.R. vaccine that year.
Efforts from local public health officials to contain outbreaks have also been hamstrung by the new health secretary, Robert F. Kennedy Jr., who has downplayed the outbreak, offered only muted support of vaccines and endorsed unproven treatments for the virus. The federal health department has also tried to cut funding to state health departments.
Andrew Nixon, a spokesperson for the Department of Health and Human Services, wrote in a statement that the department “continues to support community efforts in dealing with the measles outbreaks,” including by providing technical assistance and vaccines as requested.
He added that the C.D.C. continues to recommend vaccination as “the best way to protect against measles” and called the decision to vaccinate “a personal one.”
Another challenge in controlling this year’s outbreak is the global rise of measles. Large outbreaks have spread through Mexico and parts of Canada, which has had a record number of cases this year. This spring, the World Health Organization announced that Europe had reported the highest number of measles cases in more than 25 years.
Dr. Michael Osterholm, an epidemiologist at the University of Minnesota, attributes this to internationally declining vaccination rates, which have created “a new world order” for the spread of measles.
The global rise means the virus is constantly reintroduced into the country through visitors, giving it repeated opportunities to find pockets of unvaccinated Americans, he said.
“Unless we change the status of vaccination levels,” he said, “I don’t see it ending.”
Teddy Rosenbluth is a Times reporter covering health news, with a special focus on medical misinformation.
Jonathan Corum is a Times reporter and graphics editor focusing on science and health.
The post Measles Cases Hit Highest Total Since U.S. Eliminated the Disease appeared first on New York Times.
