With illnesses reported in at least 38 states and the District of Columbia, experts worry that measles may be here to stay, after being declared ‘eliminated’ in 2000.
More than 1,280 measles cases have been reported in the United States so far in 2025 — a 33-year high, and the largest number of recorded cases since measles was declared eliminated nationwide a quarter of a century ago.
The surge in cases this year fits definition of an epidemic, according to the Centers for Disease Control and Prevention (CDC), but if the trend continues, scientists are also concerned that measles may once again become endemic — meaning the disease will always be present within certain geographic areas.
“The increased spread means that measles in the community could be an ever-present threat, not just confined to outbreaks,” says Peter Chin-Hong, MD, an infectious disease specialist and professor of medicine at the University of California in San Francisco. “If the measles outbreak lasts for more than 12 months — which it is looking like it will in West Texas and New Mexico — it will be very probable that we will no longer consider measles eliminated in the U.S., because prolonged transmission of measles will continue, fueled by this very large outbreak.”
Elimination in the context of measles does not mean zero cases, but rather that transmission is at low enough levels to not be a major public health threat, notes Dr. Chin-Hong.
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The Southwest Remains the Center, but the Problem Is Far-Reaching
The epicenter of the measles surge continues to be in Texas, specifically Gaines County. More than 750 cases have been identified in the state since late January. Texas, along with nearby New Mexico and Kansas, accounts for about three-quarters of those infected.
According to the latest data from the Johns Hopkins Center for Outbreak Response Innovation, measles cases have been now recorded in 38 states and the District of Columbia in 2025.
Most of the measles infections nationwide have been among young people: CDC data shows that 28 percent of cases have occurred in children under 5, while kids ages 5 to 19 account for another 37 percent.
Tina Tan, MD, the president of the Infectious Diseases Society of America and a pediatric infectious disease physician at the Ann & Robert H. Lurie Children’s Hospital of Chicago, predicts that cases will continue to rise, especially during the summer months when people tend to travel.
“Measles is extraordinarily transmissible, so even if you’re standing next to an infected person at a bus stop or sitting next to a sick person in a car or plane, you can get the illness,” says Dr. Tan.
Measles Can Be Deadly
Measles can cause serious complications, such as pneumonia and swelling of the brain (encephalitis) that may require hospitalization. About 12 percent of those infected this year have needed hospital care. Young children are most likely to require hospitalization. Among kids under 5 infected with measles so far this year, about 20 percent have been hospitalized.
Three people have died from measles in 2025. Two were unvaccinated school-age children in Texas with no known underlying medical conditions, and one was an unvaccinated adult in New Mexico.
A ‘Worrisome’ Decline in Vaccination
A recent scientific report from the CDC highlights how a lack of immunization may be fueling the spread of this highly contagious rash-producing viral illness. An estimated 92 percent of people who’ve gotten measles this year were not vaccinated or had unknown vaccination status.
The authors of the CDC report stressed that measles outbreaks are becoming more frequent, especially in close-knit communities where vaccination rates are lower.
Childhood vaccination rates have been falling in the United States, especially since the start of the COVID-19 pandemic, according to research published at the end of April in JAMA.
The current U.S. measles immunization rate is considered high at above 90 percent.
But the JAMA study estimates that a 10 percent decline in the vaccination rate could lead to more than 11 million people becoming infected with the virus over a 25-year period.
“This is the highest number of measles cases since the disease was declared eliminated in the U.S. in 2000 and the most we have seen since 1992,” says Carlos del Rio, MD, a distinguished professor of medicine in the division of infectious diseases at the Emory University School of Medicine in Atlanta. ”The cause is clear: declining vaccination rates.”
Tan warns against a wealth of misinformation that has spread online regarding vaccines.
“Since the pandemic, vaccine hesitancy and vaccine skepticism have skyrocketed, because of all the anti-science information that circulates very rapidly on social media,” she says. “The fact is, this vaccine is very safe, very effective, and really is the only way you’re going to be able to protect you and your family against getting measles.”
Immunization Offers the Best Protection
The measles vaccine is highly effective and safe, and because there are no antiviral medications to treat measles, immunization offers the best protection, according to Chin-Hong.
The CDC recommends that all children get two doses of the MMR (measles-mumps-rubella) vaccine, with the first dose coming when they’re between 12 and 15 months old and the second dose when they’re between 4 and 6 years old.
Teens and adults are advised to check with their healthcare provider to make sure they are up to date on their MMR vaccination.
The National Foundation for Infectious Diseases adds that all adults born in 1957 or later who have not been vaccinated or have not had measles should be immunized. If you are not sure about your status, know that it is considered safe to get another measles vaccine.
Most people who have received two doses of the MMR vaccine do not need a measles booster shot, but some specific individuals may benefit, such as those who have undergone certain treatments for cancer and have lost some immunity. Adults born between 1963 and 1967 should check with their healthcare provider to make sure that they have immunity, as one formulation of the measles vaccine administered during that time period is considered less effective.
Check the CDC website for more details on measles vaccination.
Editor’s Note
This story has been updated. It was originally published on May 13, 2025.
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