Measles ‘Eliminated’ in US? Maybe Not for Much Longer

America’s measles resurgence is drawing renewed attention from public health officials—and it may jeopardize a major milestone the country has maintained for 25 years.

Over the past year, more than 2,200 measles cases have been reported across 45 states, the highest number in more than two decades. At least 150 people—mostly unvaccinated children—have been hospitalized, and three deaths have been recorded, marking the first measles fatalities in the U.S. in a decade, according to the New York Times. Texas has reported more than 800 cases, while South Carolina is nearing 445. Significant outbreaks have also occurred in Utah, Arizona, New Mexico, and Kansas, based on CDC data through mid-January. The virus continues to spread, with active clusters along the Utah–Arizona border and in South Carolina.

“It is startling, because just a few years ago measles was very rare in the United States,” Johns Hopkins epidemiologist Caitlin Rivers told CNN.

An international panel is now preparing to determine whether the U.S. still qualifies as having “eliminated” measles—a designation earned in 2000 after the country went at least 12 months without continuous transmission of the virus. To lose that status, health officials must demonstrate that a single chain of measles transmission has persisted for more than a year.

Making that determination is complicated. Scientists rely on genetic sequencing of virus samples and detailed tracking of how infections spread between communities. Many cases go unreported, and some patients decline to share information about travel or exposure, making it difficult to confirm whether outbreaks in different states are connected. For example, it remains unclear whether the outbreak in Texas is directly linked to those in Utah, Arizona, or South Carolina.

The CDC is working with state and local health departments to collect and analyze samples ahead of a planned presentation to the Pan American Health Organization on April 13. Canada lost its measles elimination status last year following a prolonged outbreak, and U.S. experts say a similar decision here would be largely symbolic rather than leading to travel restrictions.

Even so, public health officials warn that reversing the current trend could be far more challenging than in the past. Regaining control would require a significant increase in vaccination rates, but experts say political polarization around vaccines has made that goal increasingly difficult.

“Losing measles elimination status is an official acknowledgement that the country is on the wrong path,” Brown University epidemiologist Jennifer Nuzzo told Scientific American.

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