US Passes Grim Measles Milestone as Texas Outbreak Slows

The United States has surpassed 1,000 confirmed measles cases in 2025, reaching a critical threshold not seen since the major outbreaks of 2019 and putting the nation on pace for what could become the worst year for the disease since it was declared eliminated in 2000. While infection rates in the Texas epicenter have begun to slow, the outbreak has now spread to 30 states, with public health officials warning that declining vaccination rates nationwide continue to threaten decades of progress against the highly contagious virus.

The Centers for Disease Control and Prevention (CDC) confirmed Friday that the national case count has reached 1,001, with approximately 70% concentrated in West Texas, according to Bloomberg.

Texas Outbreak Shows Signs of Stabilizing

The Texas Department of State Health Services reported 709 confirmed measles cases since late January, with only seven new cases identified in the past week—a significant decrease from the rapid growth seen earlier in the outbreak. This represents a 1% increase compared to growth rates of 2.6% and 3.5% reported in late April, suggesting that intensive vaccination and containment efforts may be gaining traction.

“Less than one percent, or fewer than 10 of the confirmed cases, are estimated to be actively infectious,” the Texas health department stated in its May 9 update. However, officials cautioned that “due to the highly contagious nature of this disease, additional cases are likely to occur in the outbreak area and surrounding communities.”

The outbreak has extracted a heavy human toll, with 92 hospitalizations in Texas alone and three confirmed deaths nationwide—two unvaccinated school-aged children in Texas and one unvaccinated adult in New Mexico. These represent the first measles fatalities in the United States in several years.

Geographic Spread Continues Despite Containment Efforts

While growth in Texas has slowed, the outbreak’s geographic reach continues to expand. Initially centered in Gaines County in West Texas, the virus has since spread to neighboring New Mexico and Oklahoma, with Kansas also reporting cases linked to the Texas outbreak. Altogether, 30 states have now confirmed measles cases in 2025.

Health officials in Texas have shifted their approach from containment to broader immunization campaigns. The state designated eight counties with ongoing measles transmission as “outbreak counties” where special vaccination recommendations apply, including early MMR vaccine doses for infants as young as six months and additional doses for adults with only one previous vaccination.

The CDC has activated a Level 3 Incident Management Structure to provide technical assistance on diagnostics, post-exposure prophylaxis, case investigation, and other support to affected communities. Federal disease experts have been deployed to the most severely impacted areas.

Declining Vaccination Rates Fuel Vulnerability

Public health experts attribute the outbreak’s severity to falling vaccination rates, particularly in certain communities. CDC data reveal that measles vaccination rates among kindergarteners have dropped from 95.2% in the 2019-2020 school year to just 92.7% in 2023-2024, falling below the critical 95% threshold needed for effective community immunity.

The outbreak’s pattern follows a concerning trend of larger measles outbreaks in communities with low vaccination coverage. In 2019, a large outbreak in Orthodox Jewish communities in New York drove national numbers to 1,274 cases. In 2014, an outbreak in an Amish community in Ohio resulted in 383 cases.

“When more than 95% of people in a community are vaccinated, most people are protected through community immunity,” the CDC emphasized in recent guidance. This protection is particularly crucial for infants under 12 months who are too young to receive the vaccine, as well as immunocompromised individuals who cannot be vaccinated.

Demographics Reveal Preventable Tragedy

Demographic analysis of the current outbreak underscores the preventable nature of the crisis. Approximately 96% of confirmed cases nationwide involved people who were either unvaccinated or had unknown vaccination status. In Texas specifically, 99% of cases occurred in individuals without documented vaccination.

Children under five years old account for approximately 31% of cases nationwide, while individuals aged 5-19 represent about 38% of infections. Adults over 20 make up the remaining 29%, with ages unknown in a small percentage of cases.

These statistics reflect the particular vulnerability of young children to measles complications. According to the CDC, approximately 1 to 3 out of every 1,000 children with measles die from respiratory and neurological complications, even with modern medical care.

Long-Term Implications for Disease Elimination Status

The 2025 outbreak raises concerns about the United States’ measles elimination status, which declares that the disease no longer circulates continuously within the country. This status, achieved in 2000 after decades of vaccination efforts, was nearly lost during the 2019 outbreaks when continuous transmission persisted for nearly 12 months in certain areas.

Recent research from Stanford University suggests the current trajectory of declining vaccination rates could lead to measles becoming endemic again within two decades. Their modeling predicts that if current immunization rates remain unchanged, the U.S. could see an estimated 851,300 measles cases over 25 years, resulting in 170,200 hospitalizations and 2,550 deaths.

“We’re seeing the consequences of vaccine hesitancy play out in real time,” said Dr. Matthew Kiang, assistant professor of epidemiology at Stanford and lead author of the study. “This outbreak is a warning sign of what could become routine if we don’t address declining vaccination coverage.”