Measles, a disease once declared eliminated in the United States, is making a troubling comeback. As of April 15, 2025, there have been 712 confirmed cases nationwide, with more than 560 reported in Texas alone. Between January 1 and March 20, 378 cases were reported across 17 states, including California, Florida, New York, and Washington.

Measles, also known as rubeola, is a viral infection that primarily affects children. Once widespread, it is now largely preventable through vaccination. Despite this, the disease spreads easily and can lead to severe complications or even death in young children.

Tragically, two children in Texas have died from measles-related complications—marking the first such deaths in the US in over a decade. Most affected individuals are children who are either unvaccinated or have an unknown vaccination status. According to the World Health Organisation, the current US hospitalisation rate stands at approximately 17%, underscoring the disease’s severity—even in high-income countries.

In 2000, the United States officially declared measles eliminated, meaning there was no continuous transmission within its borders. This achievement was largely due to widespread use of the measles, mumps, and rubella (MMR) vaccine and robust public health surveillance. However, measles has remained endemic in various parts of the world, and imported cases have continued to appear.

The US experienced a significant spike in 2019 with 1,274 confirmed cases, but numbers declined in the following years. By 2024, the country still maintained its measles elimination status. Now, in 2025, that status is under serious threat. The resurgence—particularly in states with lower vaccination coverage—demonstrates how quickly public health progress can unravel when vigilance declines.

Understanding Measles: Symptoms, spread, and risks

Measles is a highly contagious airborne viral disease caused by the measles virus. It spreads through respiratory droplets released when an infected person coughs or sneezes and can linger in the air for up to two hours. Infected individuals can transmit the virus from four days before to four days after the appearance of the characteristic rash. Symptoms typically develop 10 to 14 days after exposure and begin with a high fever, cough, runny nose, red eyes, and small white spots inside the mouth.

This is followed by a rash that starts on the face and spreads across the body. While most people recover within two to three weeks, measles can cause serious complications—especially in young children. These include pneumonia, diarrhea, ear infections, blindness, and postinfectious encephalitis, a brain inflammation that affects about 1 in 1,000 cases and can result in long-term disability or death. There is no specific antiviral treatment for measles; vaccination remains the most effective prevention method, typically delivered as two doses of the MMR vaccine.

What might be fueling the Measles comeback?

While the exact cause of the current measles surge is still under investigation, experts cite several contributing factors: missed vaccinations during the COVID-19 pandemic, a general decline in vaccine coverage, and the growing influence of misinformation. Many children missed routine healthcare visits during the pandemic, leading to missed doses of key vaccines, including the MMR shot.

As a result, large numbers of children are now vulnerable. In 2023, the MMR vaccination rate among U.S. kindergartners dropped to 92.7%, falling below the 95% coverage needed for herd immunity. Concurrently, the spread of vaccine misinformation—particularly via social media—has intensified. The pandemic sowed confusion and mistrust, fuelling vaccine hesitancy. As more parents delay or refuse vaccinations, the conditions for a measles resurgence have been set.