Less than three months into 2025, measles cases in the United States have already surpassed last year’s total as the outbreak in West Texas continues to spread.
As of Friday, 320 cases had been reported across 16 states, according to NBC News’ tally of state health department data. That’s compared to 285 cases confirmed by the Centers for Disease Control and Prevention last year, which was the highest total since 2019.
The vast majority of this year’s cases, 259, have been in Texas, with another 35 reported in bordering New Mexico. All but four of those cases across the two states were in unvaccinated people or those with an unknown vaccination status.
An unvaccinated, school-aged child in Texas died of measles last month, and an unvaccinated adult who died in New Mexico also tested positive, but the cause of death is still under investigation. Prior to those deaths, the U.S. had not seen a measles fatality in a decade, and a child had not died of measles since 2003.
Measles has been considered eliminated in the U.S. since 2000, meaning it is not continuously spreading, though there are occasional outbreaks. But the country came close to losing that status in 2019, when 1,274 cases were recorded, most of which were associated with outbreaks in Orthodox Jewish communities in New York.
With cases now climbing in Texas and other states, public health experts worry about a renewed threat to elimination.
A global uptick in measles cases has also created more opportunities for the virus to spread in the U.S. Last year, European and Central Asian countries reported more than 127,000 measles cases, the United Nations and World Health Organization announced Thursday. That’s the highest since 1997, and double the number in 2023. Worldwide, measles cases rose 20% from 2022 to 2023, according to the latest available data from the CDC.
The WHO and U.N. attributed the increase in Europe and Central Asia to “a backsliding in immunization coverage” during the pandemic, noting that vaccination rates haven’t fully rebounded in many countries.
“Measles is back, and it’s a wake-up call,” Dr. Hans Kluge, WHO’s regional director for Europe, said in a statement Thursday, adding that “every country must step up efforts to reach under-vaccinated communities.”
Measles is one of the most contagious viruses in the world: An infected person can spread it to up to 9 out of 10 people around them if those people aren’t vaccinated. Measles can also linger in the air for up to two hours. Two doses of the measles, mumps and rubella vaccine, however, are 97% effective.
While the majority of measles cases in the U.S. are introduced from other countries, declining vaccination rates have fueled the virus’ spread locally. Health guidelines suggest a community should have a vaccination rate of at least 95% to avoid outbreaks, but by the 2023-24 school year, less than 93% of U.S. kindergartners had received the recommended two doses.
The Texas outbreak originated in Gaines County, which has an 82% kindergarten vaccination rate for measles. Vaccine hesitancy is especially prevalent among the Mennonite population in Seminole, where the outbreak’s epicenter is. Most of New Mexico’s cases are in Lea County, which borders Gaines County.
Texas and New Mexico health officials have urged unvaccinated residents to get their shots. Although the first dose is recommended at around age 1, the CDC has said infants as young as 6 months who live in areas with an outbreak can receive an early dose.
Measles is particularly dangerous for children under age 5. According to the CDC, roughly 1 to 3 out of every 1,000 children with measles die from respiratory and neurological complications.
