US Loses Measles Elimination Status After 26 Years as Cases Top 5,400
The United States has lost the measles elimination status it held for 26 years, after the Pan American Health Organization (PAHO) determined that the virus has spread continuously inside the country for more than a year.
The decision was first reported by The Wall Street Journal on Friday, 13 November, citing people familiar with the matter, and was independently confirmed by CNN the same day. Reuters also reported the ruling, which ends a public health distinction the United States has held since 2000.
PAHO itself has not yet commented publicly on the decision, and a formal announcement is expected on Tuesday, 17 November, according to NBC News and CIDRAP.
A ruling reported, not yet announced
The finding came from PAHO’s Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission, an independent panel of eight experts in epidemiology, virology, paediatrics, public health and immunisation. The panel met in Washington from 10 to 13 November to review epidemiological and laboratory evidence submitted by the US Centers for Disease Control and Prevention (CDC).
The commission examined whether the same strain of measles had been spreading from person to person inside the United States without interruption for 12 months or longer — the threshold that separates a run of imported cases from re-established local transmission.
The CDC’s report to PAHO remains confidential, but a source familiar with the agency’s findings told Reuters the CDC had concluded that the country had experienced 12 months of continuous transmission. The panel sends its findings to PAHO Director Jarbas Barbosa, who makes the final decision and communicates it to the authorities.
What elimination status means
Measles elimination does not mean the virus has vanished from a country. It means there has been no continuous homegrown transmission of the disease for at least 12 months, under high-quality surveillance. Imported cases can still occur, provided they do not seed sustained spread.
The United States earned the status in 2000, when PAHO determined the country had interrupted endemic transmission. Losing it means measles is once again classed as circulating on its own in the United States. The change does not alter the law or the medical advice: the measles vaccine remains the recommended protection, and health officials say the practical response is unchanged.
To win the status back, the United States must stop continuous spread and then remain free of an outbreak for at least 12 months.
The numbers behind the decision
The CDC counted 5,412 confirmed measles cases in the United States in 2026 as of 12 November, reported by 47 jurisdictions. The total had stood at 5,182 a week earlier, and has more than doubled the 2,289 cases recorded in all of 2025. NationWire reported earlier this month that the national total had passed 5,000 cases as health officials faced the PAHO review.
It is the highest annual total since 1991, when 9,643 cases were recorded. The CDC has logged 43 new outbreaks in 2026, and 96 per cent of this year’s confirmed cases are outbreak-associated. Reuters reported that about 96 per cent of documented infections occurred in people who were completely unvaccinated or whose vaccination records were unknown.
State health departments now report 10 measles-associated deaths in 2026, while the CDC’s own count stood at six after its latest update, a figure the agency says is subject to change. The toll includes a Wisconsin infant who died earlier this month, the first measles death in that state since 1990. Measles is not the only disease straining US public health surveillance: Florida is also facing its worst dengue outbreak since 2009.
The review period began on 20 January 2025, when the West Texas outbreak started. Evidence from Utah provided a significant indication of continued transmission: a preprint study by scientists at the state’s public health laboratory, published in August, found that one measles strain had circulated for more than a year and accounted for over 95 per cent of cases in the state.
What happens now
CDC Director Dr Erica Schwartz told Reuters before the decision that losing the status would not change the agency’s approach. “Let’s say we did lose our measles elimination status. We’re going to be doing the same thing that we’ve been doing today, which is working with the states,” she said.
The United States is not alone in losing the designation. Spain and the United Kingdom have also recently lost elimination status after reviews by World Health Organization experts, Reuters reported, and Mexico is at risk.
The United States withdrew from the World Health Organization but remains a member of PAHO, its regional arm for the Americas, which is the body that grants and removes elimination status in the region.
The ruling is a formal recognition of what the case numbers have shown for months: measles, once declared eliminated in the United States, is spreading here again.
