US Measles Cases Pass 5,000 for the First Time in 35 Years as Elimination Status Faces Review
US Measles Cases Pass 5,000 for the First Time in 35 Years as Elimination Status Faces Review
The United States has recorded 5,182 confirmed measles cases in 2026, the Centers for Disease Control and Prevention reported on November 6, the highest annual total in 35 years — and the milestone arrives just as an international panel meets in Washington to decide whether the country keeps the measles elimination status it has held since 2000.
The count, current as of November 5, is more than double the 2,289 cases recorded in all of 2025, and it is the first time the annual total has passed 5,000 since 1991, when 9,643 cases were reported. Cases have now been confirmed in 45 states and Washington, D.C., with 330 new infections reported in the latest week alone.
The numbers behind the worst year since 1991
The CDC’s weekly update paints a picture of a disease spreading fastest where vaccination has slipped. The agency has recorded 43 outbreaks in 2026, and 562 people — about 11 percent of all confirmed cases — have been hospitalized.
Children and teenagers account for most of the illness. About 59 percent of confirmed cases are in people under 20: children under five make up 18 percent, and those aged five to 19 make up 41 percent. The CDC said 96 percent of confirmed cases involved people who were unvaccinated or whose vaccination status was unknown.
Pennsylvania is the hardest-hit state, with 1,487 cases, 287 hospitalizations and six associated deaths, according to the CDC and state data reported by Reuters. South Carolina follows with 670 cases and Utah with 536.
Measles is one of the most contagious diseases known to medicine, and it is also one of the most preventable. Before the vaccine was introduced in 1963, an estimated 400 to 500 people died of measles in the United States every year, according to the CDC.
A dispute over how many people have died
The death toll has become a dispute in itself. The CDC’s national tally lists four measles-associated deaths in 2026. State health departments, however, have reported at least eight deaths linked to the disease: six in Pennsylvania, one in New York and one infant in Wisconsin.
The Wisconsin case was the state’s first measles death since 1990, and the New York child was that state’s first known measles death in more than 30 years. Three of the deaths came in a single week, according to reports based on state data.
The gap has a specific cause. The CDC, under Health Secretary Robert F. Kennedy Jr., switched from state health departments’ figures to mortality data from the National Center for Health Statistics to track measles deaths, Reuters reported. Pennsylvania counts a death as measles-associated if a confirmed case dies within 30 days of symptom onset, unless the death was due to an unrelated cause.
Pennsylvania Governor Josh Shapiro has publicly challenged the federal count, while Kennedy has questioned whether measles caused or contributed to the fatalities. The CDC said it is working with the Council of State and Territorial Epidemiologists to establish a standard definition for a measles death, and it describes its count as subject to change.
The elimination status review now under way
The stakes go beyond this year’s case count. Measles was declared eliminated in the United States in 2000, which means the virus no longer spread on its own inside the country year-round. Elimination does not mean the virus has vanished — infections can still arrive from abroad — but it does mean no continuous homegrown transmission for at least 12 months, under high-quality surveillance.
That status is now under formal review. The Pan American Health Organization’s Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission is meeting in Washington from November 10 to 13 to assess transmission data for the United States and Mexico. The review was originally scheduled as a special session in April 2026 but was postponed so authorities could complete technical analyses, including full viral genome sequencing.
The decision rests on genetics, not on how many people get sick. PAHO defines re-established endemic transmission as the uninterrupted circulation of the same virus genotype and lineage for 12 months or more in a specific geographic area. The analysis period began in January 2025, and public health experts widely expect the commission to conclude that the United States has lost its elimination status.
The meeting is closed, and the commission does not announce a ruling on its own: it sends its recommendations to PAHO’s director. “Revoking the U.S.’s elimination status would merely recognize what’s been a fact on the ground for months,” Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told Scientific American.
The Americas region as a whole already lost its measles elimination status in November 2025, after Canada experienced continuous transmission for at least 12 months. PAHO’s latest regional situation report recorded 57,666 confirmed measles cases across 17 countries and territories up to October 31, with 81 deaths: 53 in Guatemala, 23 in Mexico, three in the United States, and one each in Peru and Bolivia.
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Why vaccination rates have slipped
Behind the case numbers is a steady erosion of routine childhood immunization. Vaccination coverage for kindergarteners in the United States fell from 95.2 percent in the 2019–2020 school year to 92.4 percent during the 2025–2026 school year, according to CDC data.
That matters because measles needs about 95 percent coverage to stop spreading in a community. At 92.4 percent, the national average sits below that threshold, and coverage is lower still in many local areas — the pockets where outbreaks take hold.
The decline has many drivers, and health officials have pointed to missed routine appointments, vaccine hesitancy and uneven access to care. Whatever the mix of causes, the result is visible in the case map: 43 outbreaks across 45 states and the capital, with the largest in Pennsylvania.
Why this matters
Losing elimination status would be a formal recognition that a disease the United States once considered beaten is spreading again on its own soil. It would place the country among nations where measles circulates continuously, and it would mark a reversal of a public health achievement that took decades to build.
For families, the practical risk is immediate and concrete. Measles can cause pneumonia, brain swelling and death, and it is most dangerous for infants too young to be vaccinated and for people with weakened immune systems. The 562 hospitalizations so far this year are a reminder that the disease is not a mild childhood illness.
For the health system, the outbreaks are also expensive and disruptive. Each case triggers contact tracing, isolation and vaccination campaigns, and hospitals in the hardest-hit states have had to manage surges of highly infectious patients.
Federal health agencies have been in the spotlight this year on several fronts. In a separate move, the FDA ordered a vision-loss warning for GLP-1 weight-loss drugs, and researchers reported strong results for the Foundayo sleep apnea pill — a reminder that the same agencies managing the measles response are also making consequential decisions across medicine.
Latest developments
The PAHO commission’s Washington meeting runs through Friday, November 13, when its recommendations are expected to go to PAHO’s director. The CDC will publish its next weekly measles update on Friday, November 13, which will show whether the pace of new infections is still rising.
If the commission concludes that the same measles strain has circulated without a break for 12 months, the United States would formally lose a status it has held for 26 years. If it finds that the outbreaks are distinct and not genetically connected, the country could keep the status — an outcome some experts consider unlikely given the scale and duration of transmission since January 2025.
Either way, the case count itself is already settled history: 2026 is the worst measles year in America in 35 years, and the final total will climb further before the year ends.
Frequently asked questions
How many measles cases has the US had in 2026?
The CDC has confirmed 5,182 cases as of November 5, 2026, across 45 states and Washington, D.C. That is the highest annual total since 1991, when 9,643 cases were reported, and more than double the 2,289 cases recorded in 2025.
What does losing measles elimination status mean?
It means health authorities have found continuous homegrown transmission of the same measles strain for 12 months or more. It does not mean the virus is everywhere, but it formally recognizes that measles is spreading on its own inside the country rather than only arriving from abroad.
How many people have died of measles in the US this year?
The CDC lists four measles-associated deaths in 2026, while state health departments have reported at least eight — six in Pennsylvania, one in New York and one infant in Wisconsin. The gap comes from a change in how the CDC counts measles deaths, and the agency says it is working with state epidemiologists on a standard definition.
Is the measles vaccine effective?
Yes. The measles vaccine is highly effective, and the CDC says 96 percent of confirmed US cases in 2026 involved people who were unvaccinated or whose vaccination status was unknown. Two doses of the MMR vaccine are about 97 percent effective at preventing measles.
The final number for 2026 will not be known until the year ends, but the direction is clear. A disease the United States eliminated a quarter-century ago is back in force, and this week a panel of international experts will decide whether the official record catches up with that reality.
Sources: Centers for Disease Control and Prevention (via Reuters and USA Today); Scientific American; Euronews; London Daily News; Health and Me.
