The United States is on track to experience its highest number of measles cases in 35 years, with current projections indicating 2026 could be even worse than the current year. As of June 25, the U.S. has recorded 2,134 confirmed measles cases in 2026, approaching last year's total of 2,288, which was the highest since a 1991 outbreak.
Epidemiologist Dr. Syra Madad described the situation as a "major public health warning sign," noting that the U.S. has reached nearly last year's total with more than half of 2026 still ahead. "Unless we interrupt transmission quickly, 2026 is likely to surpass 2025 and could do so substantially," Madad warned. While outbreaks can slow with effective vaccination campaigns, isolation, and contact tracing, the current pattern is "deeply concerning."
Recent incidents highlight the disease's spread, including an exposure at Los Angeles International Airport (LAX) and a notification to diners at an Italian restaurant in New York City.
Measles is highly contagious, spreading through respiratory droplets when an infected person breathes, coughs, or sneezes. The virus can remain airborne for up to two hours after the person has left an area. Symptoms typically appear one to two weeks after exposure and can include high fever, cough, runny nose, and red, watery eyes, followed by white spots in the mouth and a rash. Individuals are contagious starting four days before the rash appears and up to four days after.
There is no cure or antiviral treatment for measles. Complications can be severe, with approximately two out of five infected individuals requiring hospitalization. Pneumonia is a common severe complication, and the disease can also lead to encephalitis, hospitalization, and even death, particularly in young children and vulnerable populations. Furthermore, measles can trigger a deadly neurological condition that may manifest decades after the initial infection.
Vaccination remains the primary method of prevention, as nearly all unvaccinated individuals exposed to measles will contract the disease. However, vaccination rates have been declining. According to the Centers for Disease Control and Prevention (CDC), 93% of measles cases this year have occurred in individuals who are unvaccinated or have an unknown vaccination status. Over half of these cases involve children aged 5 to 19. The majority of these cases were acquired domestically, indicating that measles is spreading within the U.S. rather than being solely imported.
States with significant measles activity include Utah and South Carolina, followed by Texas, Florida, Virginia, Pennsylvania, and Arizona. Utah, for instance, has seen a persistent outbreak since June 2025, with 12.8% of kindergartners unvaccinated, falling short of the 95% vaccination coverage needed to prevent widespread outbreaks.
Madad emphasized that measles elimination, declared in the U.S. in 2000, is not permanent and requires consistent high vaccination coverage, rapid outbreak detection, and strong public health responses. If vaccination gaps persist, the U.S. risks further outbreaks, disruptions to schools and childcare, and increased strain on health departments, along with the continued threat of severe illness and death from a preventable disease.
Despite the concerning trends, Madad stated that the situation is "recoverable." The U.S. has achieved measles elimination before and can regain control by restoring high MMR (measles, mumps, rubella) vaccination coverage, strengthening surveillance systems, and responding swiftly to every case.