The United States is on the brink of surpassing last year’s total measles cases, putting the country on track to set a new record before summer’s end.
The impending milestone underscores how the country has entered a new phase in its battle with measles, with repeated new infections of the deadly disease igniting sustained outbreaks in multiple states rather than staying concentrated in a few undervaccinated communities.
Since an unvaccinated child in West Texas developed measles early last year, successive outbreaks have sickened thousands of people and have now spread to 39 states, the District of Columbia and New York City. Last year, the U.S. reported 2,288 measles cases, the highest since measles was eliminated in 2000 and the most in more than three decades. The U.S. is now poised to reach that level in roughly half the time, with 2,170 measles cases as of July 2, according to the CDC.
As vaccination rates decline and measles spreads wider, those outbreaks are becoming harder to extinguish. There are fewer people to investigate cases, communities most affected often remain difficult to reach, and a generation of doctors is getting a crash course in diagnosing and managing a disease many have rarely — if ever — encountered. State health officials fear their outbreaks may never end and say the actual number of cases is far higher than official counts reflect.
“Maybe we’ll get it under control here in Utah, but other states will go through what we just experienced, and then it will come back here,” said Utah state epidemiologist, Leisha Nolen. Utah is now home to the largest active outbreak. “I have concerns that this could be the future for a while.”
Utah’s measles outbreak, which began in an isolated community along the Arizona border in June 2025, has spread into nearly every county in the state. Although transmission has slowed, Nolen worries new “introductions,” the initial establishment of a disease into a new geographic region, could reignite it when schools reopen. More than 680 people have been sickened, with more than 500 infections this year.
A genetic analysis suggests the true number of Utah’s cases is probably four times higher, Nolen said.
Health officials in Virginia, Pennsylvania and other states have similar fears about continued introductions.
“I think we’ve seen a threshold where there are introductions happening all the time, all over the place,” said Andrew Pavia, an infectious-disease physician and professor of pediatrics and medicine at the University of Utah.
Public health officials and infectious-disease experts say several factors account for the rapid spread of measles this year.
“Clinicians really haven’t thought about measles,” said Patsy Stinchfield, executive director of the new group, the Measles Collaborative. “They skipped that chapter in medical school” because the U.S. eliminated the disease more than a quarter-century ago, she said. “And here they are now, having to diagnose it.”
The group is developing an app to help doctors diagnose measles. It is creating hospital checklists and clinical algorithms to guide the complicated logistics of safely caring for patients. Because the virus can remain suspended in the air for up to two hours, hospitals must carefully determine where patients are evaluated, isolated and treated.
To counter misinformation on social media, the group plans to create TikToks and Instagram posts for parents to explain the basics of measles, including how sick children can get.
Most children recover after several miserable days of fever, cough, congestion and pink eye.
But measles can also cause pneumonia, brain swelling, deafness, intellectual disability and death. It can trigger a rare but invariably fatal brain disease, subacute sclerosing panencephalitis, or SSPE, years after the initial infection.
Pavia worries many parents still underestimate how sick measles can make children.
“People aren’t really motivated by fear of the rare, terrible thing,” said Pavia, who has cared for children hospitalized for measles. “What I think would help much more is if people realized that they would see their 4-year-old sicker than they’ve ever been. Moaning and crying in bed or needing to be hospitalized for two or three days on oxygen, fighting to breathe.”
Some doctors worry about what happens after children recover.
Measles can erase immune memory, leaving children temporarily vulnerable to infections such as influenza and covid-19 — even if they had previously been vaccinated or infected. Those infectious diseases could result in a whole new set of complications. In recent years, the country has seen some of the highest numbers of flu deaths among children in decades.
“That means those people who get measles now get to have flu, get to have covid, essentially as if they were getting those infections for the first time,” Nolen said.
The impending milestone underscores how the country has entered a new phase in its battle with measles, with repeated new infections of the deadly disease igniting sustained outbreaks in multiple states rather than staying concentrated in a few undervaccinated communities.
Since an unvaccinated child in West Texas developed measles early last year, successive outbreaks have sickened thousands of people and have now spread to 39 states, the District of Columbia and New York City. Last year, the U.S. reported 2,288 measles cases, the highest since measles was eliminated in 2000 and the most in more than three decades. The U.S. is now poised to reach that level in roughly half the time, with 2,170 measles cases as of July 2, according to the CDC.
As vaccination rates decline and measles spreads wider, those outbreaks are becoming harder to extinguish. There are fewer people to investigate cases, communities most affected often remain difficult to reach, and a generation of doctors is getting a crash course in diagnosing and managing a disease many have rarely — if ever — encountered. State health officials fear their outbreaks may never end and say the actual number of cases is far higher than official counts reflect.
“Maybe we’ll get it under control here in Utah, but other states will go through what we just experienced, and then it will come back here,” said Utah state epidemiologist, Leisha Nolen. Utah is now home to the largest active outbreak. “I have concerns that this could be the future for a while.”
Utah’s measles outbreak, which began in an isolated community along the Arizona border in June 2025, has spread into nearly every county in the state. Although transmission has slowed, Nolen worries new “introductions,” the initial establishment of a disease into a new geographic region, could reignite it when schools reopen. More than 680 people have been sickened, with more than 500 infections this year.
A genetic analysis suggests the true number of Utah’s cases is probably four times higher, Nolen said.
Health officials in Virginia, Pennsylvania and other states have similar fears about continued introductions.
“I think we’ve seen a threshold where there are introductions happening all the time, all over the place,” said Andrew Pavia, an infectious-disease physician and professor of pediatrics and medicine at the University of Utah.
Public health officials and infectious-disease experts say several factors account for the rapid spread of measles this year.
U.S. vaccination rates are plunging. See where your school stands.
Doctors confront a disease they have never seen
In a sign of how seriously physicians view the threat, more than a dozen medical and public health organizations launched an unusual effort this month to help prepare doctors and hospitals for a disease many practicing physicians have rarely — or never — encountered but may now need to manage as part of everyday practice.“Clinicians really haven’t thought about measles,” said Patsy Stinchfield, executive director of the new group, the Measles Collaborative. “They skipped that chapter in medical school” because the U.S. eliminated the disease more than a quarter-century ago, she said. “And here they are now, having to diagnose it.”
The group is developing an app to help doctors diagnose measles. It is creating hospital checklists and clinical algorithms to guide the complicated logistics of safely caring for patients. Because the virus can remain suspended in the air for up to two hours, hospitals must carefully determine where patients are evaluated, isolated and treated.
To counter misinformation on social media, the group plans to create TikToks and Instagram posts for parents to explain the basics of measles, including how sick children can get.
Most children recover after several miserable days of fever, cough, congestion and pink eye.
But measles can also cause pneumonia, brain swelling, deafness, intellectual disability and death. It can trigger a rare but invariably fatal brain disease, subacute sclerosing panencephalitis, or SSPE, years after the initial infection.
Pavia worries many parents still underestimate how sick measles can make children.
“People aren’t really motivated by fear of the rare, terrible thing,” said Pavia, who has cared for children hospitalized for measles. “What I think would help much more is if people realized that they would see their 4-year-old sicker than they’ve ever been. Moaning and crying in bed or needing to be hospitalized for two or three days on oxygen, fighting to breathe.”
Some doctors worry about what happens after children recover.
Measles can erase immune memory, leaving children temporarily vulnerable to infections such as influenza and covid-19 — even if they had previously been vaccinated or infected. Those infectious diseases could result in a whole new set of complications. In recent years, the country has seen some of the highest numbers of flu deaths among children in decades.
“That means those people who get measles now get to have flu, get to have covid, essentially as if they were getting those infections for the first time,” Nolen said.
