US records 2,170 measles cases in 2026 and is expected to lose its elimination status at a November PAHO review

Summary

The United States confirmed 2,170 measles cases in 2026 as of July 2, across 41 states and 31 outbreaks, the highest annual total since measles elimination was declared in 2000. Three people have died in the combined 2025-2026 outbreak, the first US measles deaths since 2015. South Carolina's outbreak reached 847 cases, surpassing Texas in 16 weeks rather than the seven months Texas needed to reach its total. About 92% of confirmed 2026 cases involved unvaccinated individuals or those with unknown vaccination status. The Pan American Health Organization is scheduled to formally assess the US's measles elimination status in November 2026, and epidemiologists and CIDRAP widely expect the assessment will confirm the US has lost the designation, following Canada in 2025. In Europe, WHO confirmed in January 2026 that six countries, Armenia, Austria, Azerbaijan, Spain, the United Kingdom, and Uzbekistan, had already lost elimination status based on 2024 data, and measles is now considered endemic in 13 European countries.

The split

US public health authorities and CDC attributed the outbreak to falling vaccination rates, pointing to county-level data showing measles-mumps-rubella coverage below the 95% threshold needed for herd immunity in hundreds of US school districts. Vaccine hesitancy advocates and some elected officials at the state level publicly questioned the severity of the outbreak or disputed the public health consensus on vaccination, contributing to the policy environment in which coverage dropped. International public health observers compared the US situation to the European outbreak cycle of 2018-2020 and cautioned that once chains of transmission become entrenched in low-coverage communities, restoration of herd immunity takes years of sustained catch-up vaccination.

By the numbers

• 2,170 confirmed measles cases in the US as of July 2, 2026 (41 states, 31 outbreaks)
• 3 deaths: 2 unvaccinated children in Texas, 1 unvaccinated adult in New Mexico (first since 2015)
• 847 cases: South Carolina's outbreak total, the largest single-state outbreak of the combined period
• 92% of confirmed 2026 cases: unvaccinated or unknown vaccination status
• November 2026: scheduled PAHO measles elimination status assessment for the US
• 6 European countries lost elimination status January 2026: Armenia, Austria, Azerbaijan, Spain, UK, Uzbekistan
• 13 European countries where measles is now considered endemic

Why it matters

The US losing measles elimination status would be the highest-profile reversal of a public health milestone in a wealthy country in the modern vaccine era, and would join a widening global pattern of Measles resurgence driven by vaccination coverage decline. For global health financing, the US case reinforces arguments made since 2024 that vaccine hesitancy is no longer a problem confined to lower-income settings with limited health system reach. The loss of elimination status also has practical consequences: countries that maintain elimination status carry lower screening requirements for international travelers arriving from them.

What to watch

• PAHO's November 2026 formal assessment of US elimination status
• Whether South Carolina's outbreak continues to grow beyond 847 cases
• Federal and state vaccination catch-up campaign rollout and uptake data
• Whether any of the 13 European endemic countries launches large-scale measles vaccination campaigns before the next outbreak cycle