moving Backward With over 900 US measles cases so far this year, things are looking bleak US hasn't seen this many cases this early in a year since the 1990s before we hit "elimination." Beth Mole – Apr 25, 2025 6:03 pm | 2 Measles rash on the body of the child. Credit: Getty | Povorozniuk Liudmyla Measles rash on the body of the child. Credit: Getty | Povorozniuk Liudmyla Story text Size Small Standard Large Width * Standard Wide Links Standard Orange * Subscribers only   Learn more As of Friday, April 25, the US has confirmed over 900 measles cases since the start of the year. The cases are across 29 states, but most are in or near Texas, where a massive outbreak continues to mushroom in close-knit, undervaccinated communities. On April 24, the Centers for Disease Control and Prevention had tallied 884 cases across the country. Today, the Texas health department updated its outbreak total, adding 22 cases to its last count from Tuesday. That brings the national total to at least 906 confirmed cases. Most of the cases are in unvaccinated children and teens. Overall, Texas has identified 664 cases since late January. Of those, 64 patients have been hospitalized, and two unvaccinated school-aged children with no underlying medical conditions have died of the disease. An unvaccinated adult in New Mexico also died from the infection, bringing this year's measles death toll to three. The cases and deaths are breaking records. In the past 30 years, the only year with more measles cases than the current tally was 2019, which saw 1,274 cases. Most of those cases were linked to large, extended outbreaks in New York City that took 11 months to quell. The US was just weeks away from losing its elimination status, an achievement earned in 2000 when the country first went 12 months without continuous transmission. Since 2019, vaccination coverage of the measles, mumps, and rubella (MMR) vaccine among US kindergartners has only fallen. National rates fell from 95 percent in 2019—the threshold considered necessary to keep measles from spreading—to 92.7 percent in the 2023–24 school year, the most recent year for which there's data. On the brink In 2019, amid the record annual case tally, cases had only reached a total of 704 by April 26. With this year's tally already over 900, the country is on track to record a new high. Before 2019, the next highest case total for measles was in 1994. That year, the country saw 899 cases, which 2025 has already surpassed. In terms of deaths, the US last saw a measles fatality in 2015, when an immunocompromised adult died of the infection. The last time the country saw the death of a child was in 2003, when there were two deaths. The second death that year was a 75-year-old. Experts are understandably concerned that the US is at risk of losing its elimination status this year and that measles will once again circulate endemically in the country. In a modeling study published Thursday in JAMA, Stanford University researchers and colleagues concluded that measles "may be likely to return to endemic levels within the next 20 years, driven by states with routine vaccination coverage below historical levels and below the threshold needed to maintain elimination of transmission." If current vaccination levels are maintained, the model estimated that the US will see around 850,000 measles cases over the next 25 years, with about 170,000 hospitalizations and 2,500 deaths. If vaccination levels fall by 10 percent, estimated cases in the next 25 years would rise to 11 million. In a measles update published Thursday by the Centers for Disease Control and Prevention, agency researchers also warned that the US is heading backward to an era where measles is constantly present and spreading in the US. "[R]ecent increasing global measles incidence in areas frequently visited by US travelers, coupled with declines in MMR vaccination coverage in many U.S. jurisdictions to <95% ... and spread of measles from ongoing domestic outbreaks to other jurisdictions, have increased the risk for ongoing measles transmission within the United States," the researchers wrote. They called for more vaccination: "Increasing national and local MMR vaccination coverage is essential to preventing measles cases and outbreaks." Beth Mole Senior Health Reporter Beth Mole Senior Health Reporter Beth is Ars Technica’s Senior Health Reporter. Beth has a Ph.D. in microbiology from the University of North Carolina at Chapel Hill and attended the Science Communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes. 2 Comments