US Loses Measles Elimination Status as Cases Top 5,400 in Worst Outbreak Since 1991, With Deaths Climbing

ATLANTA — The United States has lost the measles elimination status it held for more than a quarter-century, according to multiple reports. The country is battling its worst outbreak of the highly contagious disease in decades.

The Pan American Health Organization, the Americas arm of the World Health Organization, revoked the designation after finding that the virus had spread continuously in the U.S. for more than a year, The Wall Street Journal reported Friday. Reuters, CNN and other outlets also reported the decision.

The ruling followed a meeting of PAHO's measles and rubella re-verification commission, held Nov. 10-13. The commission reviewed epidemiological and laboratory evidence from the U.S. Centers for Disease Control and Prevention to determine whether the same strain had been circulating for at least 12 months.

The U.S. declared measles eliminated in 2000.

Cases Hit 35-Year High

The CDC on Friday reported 5,412 confirmed measles cases nationwide as of Nov. 12, up 230 from its previous update. It is the highest annual total since 1991 and more than double the 2,289 cases recorded in all of 2025.

Cases have been reported in 47 states, the District of Columbia and New York City. According to CDC data:

591 people, or 11% of all cases, have been hospitalized. About 58% of cases have been in people under 19. 96% of cases have been in people who were unvaccinated or whose vaccination status was unknown.

The CDC has confirmed six measles-associated deaths this year. State health departments have reported eight: six in Pennsylvania and one each in New York and Wisconsin.

Pennsylvania has been hit hardest, with more than 1,500 cases this year. New York's governor declared a measles emergency in October.

"The fact that there have been six deaths amidst an outbreak that has affected over 5,000 Americans for an entirely preventable disease is a travesty of our public health system," said Dr. Thomas Lew, an assistant clinical professor of medicine at Stanford University School of Medicine.

Falling Vaccination Rates

Health experts link the resurgence to declining vaccination rates. MMR vaccination coverage among U.S. kindergartners has fallen from 95.2% in the 2019-2020 school year to 92.4% in 2025-2026, below the roughly 95% threshold experts say is needed to prevent outbreaks.

Measles is one of the most contagious diseases known. It can cause high fever, rash, pneumonia, brain swelling and death. The two-dose MMR vaccine, which protects against measles, mumps and rubella, is about 97% effective at preventing the disease.

Only about 2% of this year's cases involved people who had received both recommended doses.

The outbreak has also become politically charged. Pennsylvania Gov. Josh Shapiro and U.S. Health Secretary Robert F. Kennedy Jr. have clashed over how measles deaths are counted. Kennedy has faced criticism from public health experts over his past skepticism of vaccines.

What Losing the Status Means

Measles elimination does not mean zero cases. It means the disease is no longer spreading continuously within a country, and that new cases mostly come from travelers infected abroad.

Losing the status means measles is again considered to be circulating within the U.S.

William Moss, an epidemiology professor at the Johns Hopkins Bloomberg School of Public Health, said the loss damages the country's reputation as a public health leader. For ordinary Americans, he said, it means continued large outbreaks and a higher risk of illness, hospitalization and death.

Regaining the status will be difficult. A country must stop transmission and go at least 12 months without continuous spread.

"So it's not going to be a trivial task for the United States to regain its measles elimination status," Moss said.

CDC Response

CDC Director Dr. Erica Schwartz told Reuters before the decision that the agency's approach would not change if the U.S. lost its status. She said it would keep doing "the same exact thing," working with states to encourage immunization.

The U.S. joins other countries that have recently lost elimination status. Canada lost its status in 2025, and Spain and the United Kingdom have also lost theirs. Mexico, which has had large outbreaks of its own, is also at risk.

Health officials urge anyone who is unsure of their vaccination status to talk with a doctor or pharmacist about getting the MMR vaccine.