Measles spread; renew fear that US could lose its long standing elimination status
TOI GLOBAL DESK | TOI GLOBAL | Jan 22, 2026, 21:35 IST
Should measles continue spreading nationwide, the country’s hard-won elimination status may be at risk, according to health officials. A rise in outbreaks over the past year, together with fewer people receiving vaccines, has raised concern among medical professionals. The progress made so far now faces challenges due to these shifting patterns in public immunity.
TL;DR
Twelve months on from a deadly measles surge in Texas, cases continue nationwide. Despite efforts to contain it, transmission lingers, fueled by shrinking vaccination rates. Experts now question whether the disease’s official absence can still hold. The threshold once met now slips out of reach. Transmission that lasts too long weakens prior progress. Fewer people receiving immunizations adds pressure to containment efforts. Status changes could follow if trends hold.
One year has passed since a fatal measles outbreak emerged in West Texas. Since then, cases have moved into various parts of the nation. This ongoing movement troubles officials who monitor population health. Their worry stems from a key benchmark used worldwide. Measles is classified as continuously present if local spread lasts twelve months or more. Right now, evidence suggests the U.S. may fall short of maintaining its eliminated status. That shift would mark a notable change in disease control progress.
Measles was considered gone from regular circulation in the U.S. by 2000, even though occasional cases arrived through travelers from abroad. Now, that achievement faces uncertainty. At George Mason University, Amira Albert Roess, specializing in global health and disease patterns, observed signs pointing toward possible loss of elimination status. In past decades, such setbacks mostly followed deep societal disruptions, not seen here until recently.
Data from the Centers for Disease Control and Prevention show that 2,242 measles cases occurred across the United States in 2025, along with 49 separate outbreaks, the most recorded in a single year since 1991. As of now, an additional 171 infections have been officially identified during the current month; however, specialists believe actual totals may be greater due to delays between state-level detection and national reporting. Since October, South Carolina's health agency has documented 646 instances, positioning it at the center of recent transmission activity.
Even so, national officials have treated the possible loss of elimination status as minor. During a recent media briefing, Dr. Ralph Abraham, recently appointed principal deputy director at the CDC, noted the label holds limited weight. Respect for personal decision-making took priority in his remarks. Communities opting out of vaccination, he observed, act within their right to do so.
A decision now faces the Pan American Health Organization, part of the World Health Organization, caught between paths. While adherence to protocol continues across the board, separate investigations emerge, Noel Brewer, professor in public health at the University of North Carolina at Chapel Hill, proceeds independently. His group prepares to deliver findings on how the United States handled outbreaks, directed toward PAHO. Continuous transmission of one viral variant for twelve months or more defines loss criteria within their framework. Therefore, standing may remain unchanged despite current conditions. That outcome hinges strictly on duration, according to stated guidelines.
During November, Acting CDC Director Jim O'Neill noted the Utah and Arizona incidents showed no direct connection to the Texas event. This earlier incident started within a rural Mennonite population where few had received vaccines. At 762, the count of those infected stood. Among the losses: a pair of children in Texas without immunization, alongside an adult in New Mexico never vaccinated.
Not every expert shares that view. Measles spread within the country, according to Dr. Demetre Daskalakis, previously leading the CDC’s immunization division, is beyond containment. Formal labels aside, he stated, elimination no longer reflects reality.
Still at the core of discussion are immunization levels. Exposure leads to infection in roughly nine out of ten unvaccinated individuals, due to measles’ strong transmission ability. Sustained outbreaks were rare for years, supported by consistently high vaccine uptake across the country. Recently, though, several states show drops beneath the 95 percent mark. During the academic period from 2024 into 2025, thirty-nine states recorded coverage short of recommended levels, data from KFF indicates.
A new analysis in JAMA, stemming from work by NBC News and Stanford researchers, shows growing numbers of kindergartners avoiding vaccines across much of the United States. When immunity slips below critical thresholds, disease spread becomes more probable. Because protection levels remain below what is needed, experts express concern about ongoing vulnerability to measles. With fewer vaccinated children county by county, public health safeguards weaken gradually. Should trends persist, reestablished transmission chains could threaten decades-old control achievements.
FAQs
Twelve months on from a deadly measles surge in Texas, cases continue nationwide. Despite efforts to contain it, transmission lingers, fueled by shrinking vaccination rates. Experts now question whether the disease’s official absence can still hold. The threshold once met now slips out of reach. Transmission that lasts too long weakens prior progress. Fewer people receiving immunizations adds pressure to containment efforts. Status changes could follow if trends hold.
One year has passed since a fatal measles outbreak emerged in West Texas. Since then, cases have moved into various parts of the nation. This ongoing movement troubles officials who monitor population health. Their worry stems from a key benchmark used worldwide. Measles is classified as continuously present if local spread lasts twelve months or more. Right now, evidence suggests the U.S. may fall short of maintaining its eliminated status. That shift would mark a notable change in disease control progress.
Measles was considered gone from regular circulation in the U.S. by 2000, even though occasional cases arrived through travelers from abroad. Now, that achievement faces uncertainty. At George Mason University, Amira Albert Roess, specializing in global health and disease patterns, observed signs pointing toward possible loss of elimination status. In past decades, such setbacks mostly followed deep societal disruptions, not seen here until recently.
Data from the Centers for Disease Control and Prevention show that 2,242 measles cases occurred across the United States in 2025, along with 49 separate outbreaks, the most recorded in a single year since 1991. As of now, an additional 171 infections have been officially identified during the current month; however, specialists believe actual totals may be greater due to delays between state-level detection and national reporting. Since October, South Carolina's health agency has documented 646 instances, positioning it at the center of recent transmission activity.
Even so, national officials have treated the possible loss of elimination status as minor. During a recent media briefing, Dr. Ralph Abraham, recently appointed principal deputy director at the CDC, noted the label holds limited weight. Respect for personal decision-making took priority in his remarks. Communities opting out of vaccination, he observed, act within their right to do so.
A decision now faces the Pan American Health Organization, part of the World Health Organization, caught between paths. While adherence to protocol continues across the board, separate investigations emerge, Noel Brewer, professor in public health at the University of North Carolina at Chapel Hill, proceeds independently. His group prepares to deliver findings on how the United States handled outbreaks, directed toward PAHO. Continuous transmission of one viral variant for twelve months or more defines loss criteria within their framework. Therefore, standing may remain unchanged despite current conditions. That outcome hinges strictly on duration, according to stated guidelines.
During November, Acting CDC Director Jim O'Neill noted the Utah and Arizona incidents showed no direct connection to the Texas event. This earlier incident started within a rural Mennonite population where few had received vaccines. At 762, the count of those infected stood. Among the losses: a pair of children in Texas without immunization, alongside an adult in New Mexico never vaccinated.
Not every expert shares that view. Measles spread within the country, according to Dr. Demetre Daskalakis, previously leading the CDC’s immunization division, is beyond containment. Formal labels aside, he stated, elimination no longer reflects reality.
Still at the core of discussion are immunization levels. Exposure leads to infection in roughly nine out of ten unvaccinated individuals, due to measles’ strong transmission ability. Sustained outbreaks were rare for years, supported by consistently high vaccine uptake across the country. Recently, though, several states show drops beneath the 95 percent mark. During the academic period from 2024 into 2025, thirty-nine states recorded coverage short of recommended levels, data from KFF indicates.
A new analysis in JAMA, stemming from work by NBC News and Stanford researchers, shows growing numbers of kindergartners avoiding vaccines across much of the United States. When immunity slips below critical thresholds, disease spread becomes more probable. Because protection levels remain below what is needed, experts express concern about ongoing vulnerability to measles. With fewer vaccinated children county by county, public health safeguards weaken gradually. Should trends persist, reestablished transmission chains could threaten decades-old control achievements.
FAQs
- What does measles elimination mean?
This indicates absence of ongoing viral spread within a nation, despite occasional isolated cases appearing. Still, transmission does not persist across communities. Rare instances may emerge without signaling widespread activity. - Could it be that the United States no longer holds its elimination certification?
Not at that time. An official determination from the Pan American Health Organization likely will come in November.