Measles On the Rise: Global Surge and US Status at Risk

Measles is making a troubling comeback worldwide, and the United States may lose its status as a country that has eliminated the disease. In the last 5 years, new cases have been reported in more than 100 countries.¹ As per the CDC, the total number of measles cases in the US was 1723 confirmed by laboratory testing as of November 12, 2025. The country had 45 different outbreaks, and 87% of confirmed cases are outbreak-associated.²

US Elimination Status: On the Brink

The New York Times obtained a recording of a telephone call wherein CDC and state health officials link the outbreak that began in January in Texas to contemporaneous outbreaks in Utah and Arizona—a connection that could end the US’s 25-year measles elimination status.^3,4 The chain of transmission began in a conservative Mennonite group at the edge of Texas in January and spread to Oklahoma and New Mexico.⁴ If sustained transmission continues past the anniversary of the first Texas cases, the US could lose elimination status, a designation maintained since 2000.

“CDC and state and local health agencies continue to work together to assess transmission patterns and ensure an effective public health response—which is what led to the Texas outbreak being declared over,” Andrew Nixon, a representative from the Department of Health and Human Services, said in a statement.³

Losing elimination status may not trigger immediate travel restrictions, yet for a high-resource country like the US, it would symbolize a significant lapse in public-health protection.⁴ The strain now circulating, identified as genotype 9171, “continues, unfortunately uninterrupted, across multiple jurisdictions,” according to CDC measles-response lead David Sugerman, MD,MPH.⁴

What’s Driving the Measles Resurgence?

Globally, the latest increase is connected to areas where measles vaccination has not been sufficiently provided: for example, around 10.3 million people are thought to have been infected in 2023.⁵ The pathogen "has no respect for borders," and any locality that has some residents who have not been immunized can be infected.² In the US, most of the cases are among individuals who have not been vaccinated or whose vaccination status is unknown.²

The Utah-Arizona outbreak has over 180 cases in total, with a substantial number among household contacts of known cases. However, approximately ¼ of the cases are of unknown origin, suggesting that there may be uncharacterized chains of transmission.⁴

What Does This Mean for Pharmacists?

For pharmacy teams and immunization-program leaders, this resurgence reinforces the need to revisit fundamental practices: making sure they check vaccine histories, confirm that 2 doses of the measles-mumps-rubella (MMR) vaccine are given, and inform patients of the need to be vaccinated without delay. Measles remains one of the viruses that spreads fastest to humans; a single infected individual can pass the virus to as many as 90% of susceptible contacts.⁵

Pharmacists have a special role in the prevention of an outbreak: they are able to find adults who have not been sufficiently vaccinated (for instance, people born in 1957 or later without any documented immunity), provide education on the high effectiveness of 2-dose MMR vaccination, and work with public health partners when local outbreaks are identified.

A Defining Moment for Immunization in the US

The combination of a worldwide measles rebound, domestic outbreaks, and the possibility that the United States may lose its elimination status marks a turning point for immunization policy and practice. The 2025 confirmed case count is already the highest since elimination, and domestic chains of transmission have been found to extend across several states.² The New York Times report emphasizes that the US elimination record is not immune to challenges.³

For pharmacists, this means more than static vaccine-stock management or running routine catch-up programs. It entails going deeply into the outbreak immunization strategy: prioritizing surveillance in communities that have low coverage, then being ready to respond immediately if clusters appear, and encouraging the message that every unvaccinated person is a possible link in the transmission chain. The return to elimination may be a label, but strong immunization and outbreak response are the active defense.

REFERENCES

1. Ferguson S. Over the past five years, measles outbreaks have hit more than 100 countries. Canada lost its official measles elimination status this week. The United States could be next. UNICEF USA. Published November 12, 2025. Accessed November 19, 2025. https://www.unicefusa.org/stories/measles-cases-are-soaring-globally-heres-what-you-need-know

2. Centers for Disease Control and Prevention. Measles cases and outbreaks. Measles (Rubeola). Published April 25, 2025. Accessed November 19, 2025. https://www.cdc.gov/measles/data-research/index.html

3. Apoorva Mandavilli, Rosenbluth T. C.D.C. Links Measles Outbreaks in Multiple States for First Time. The New York Times. Published November 18, 2025. Accessed November 19, 2025. https://www.nytimes.com/2025/11/17/health/measles-us-elimination-status-outbreaks.html

4. CDC. Global Measles Outbreaks. Global Measles Vaccination. Published May 13, 2024. Accessed November 19, 2025. https://www.cdc.gov/global-measles-vaccination/data-research/global-measles-outbreaks/index.html

5. Center for Infectious Disease Research and Policy. CIDRAP. Published November 18, 2025. Accessed November 19, 2025. https://www.cidrap.umn.edu/measles/utah-south-carolina-confirm-more-measles-cdc-call-suggests-us-elimination-status-jeopardy