Measles cases are now the highest they’ve been in 33 years.
As of July 8, reported cases totaled 1,288, surpassing the outbreak numbers from 2019, when cases reached 1,274, according to the CDC. To find a year with a greater number of cases, you have to go back to 1992, when the United States had 2,126 cases.
More than 100 cases have been added to this year’s total since June 1, which is a decrease from the peak on March 30 when 114 cases were reported in one week. There have been three deaths, with no increase since early April. While there have been no new deaths, this record-breaking number is concerning, especially in terms of the United States’ elimination status, experts said.
Measles Cases by the Numbers
In 2025, most measles cases have been among children: 29% (368) were in children younger than 5 years of age, and 36% (469) were in those 5 to 19 years of age. The final 34% of cases (439) were in individuals older than 20 years of age, and in 12 cases, the age was unknown.
Most of the cases have been in Texas, which now totals more than 700 cases. There have been 27 outbreaks in the United States this year, with 88% of cases linked to these outbreaks.
Of all measles cases, 13% of individuals (162) have been hospitalized. Among the three age groups, children younger than 5 years of age have the highest proportion of individuals hospitalized at 21% (77/368). In comparison, 8% of children between 5 and 19 years of age were hospitalized (37/469), and 11% of adults 20 years of age and older were hospitalized (47/439).
The vast majority of measles cases—92%—were in people who were unvaccinated or have unknown vaccination status. The rest had either one dose of the measles, mumps and rubella (MMR) vaccine (4%) or two doses (4%).
Understanding Infection Risk
A spokesperson at the CDC, who asked not to be identified, said the CDC is still providing technical assistance, laboratory support and vaccines as requested. However, the risk for measles infection is low for the overall U.S. population, with a case rate of less than 0.4 per 100,000 people.
However, Walter Orenstein, MD, DSc (Hon), an emeritus professor of medicine, pediatrics, global health and epidemiology at Emory University, in Atlanta, reminded Infectious Disease Special Edition about how contagious measles can be. “It is the most contagious of the vaccine-preventable diseases, needing a herd immunity threshold of 92% to 94% immunity to provide community protection. This requires vaccination rates of 95% or more to reach that immunity level.”
Therefore, not reenforcing the value of vaccination and not urging people to get vaccinated will eventually erode the herd protection that currently exists in these areas.
In this outbreak, “measles risk is higher in U.S. communities with low vaccination rates in areas with active measles outbreaks or with close social and/or geographic linkages to areas with active measles outbreaks. CDC continues to recommend MMR vaccines as the best way to protect against measles,” the spokesperson said.
Elimination Status in the Balance
After cases reached a high in the United States of 27,808 in 1990, measles declined throughout the country, leading to a declaration of measles elimination in the United States in 2000. This elimination status was due to a “highly effective vaccination program in the United States, as well as a better measles control in the Americas region,” according to the CDC.
But just as during the 2019 outbreak, the high number of cases is causing some to fear the United States is hanging in the balance. “I am very concerned that we could lose our elimination status,” Dr. Orenstein told IDSE.
Dr. Orenstein, who was the director of the CDC’s National Immunization Program from 1988 to 2004, said for this highly contagious disease, which is known to have many possible complications, vaccination is the key to preventing disease spread. “Measles vaccines are safe and highly effective in preventing measles both in the individual vaccinee and stopping spread of the infection,” he said. This not only protects vaccinated individuals but indirectly protects people who can’t be vaccinated because of “legitimate medical contraindications to vaccination,” compromised immune systems, ineligibility (e.g., young infants) and about 3% of people who do not develop a durable immune response, Dr. Orenstein said.
Vaccines Abroad
It’s not just U.S. cases that are worrying to Dr. Orenstein. “Every single measles case in the United States this year is due to imported virus, either brought back from other countries by U.S. travelers or foreign visitors,” he said. “Helping other countries enhance their immunization programs is a win-win situation.” Therefore, stopping U.S. support of global vaccination efforts is concerning, he said, because those efforts also protect our own population.
“We all need to advocate for vaccination with our families, our neighbors, our friends and anyone we know, that all persons recommended for vaccination get vaccinated both for their own benefit and their community’s benefit,” he said.
