Measles cases in the U.S. have decreased, yet the commencement of the school year increases the possibility of further spread.
In the United States, the number of measles cases is on the rise, despite a recent decrease in outbreak-related cases in Texas. The increase is now driven by multiple new outbreaks across numerous states, rather than being solely attributed to the initial large West Texas outbreak.
The resurgence of measles is largely due to several key factors. Firstly, vaccination rates have declined during and after the COVID-19 pandemic, failing to rebound to the 95% coverage needed for herd immunity. This leaves more people susceptible to infection.
Secondly, measles is a highly contagious disease. One infected individual can infect up to 18 others in unvaccinated populations, making it easier for the virus to spread.
Thirdly, the global circulation of measles has led to travel-related importations of the virus into the US.
As of early August 2025, there have been 32 outbreaks nationwide this year, compared with only 16 in 2024, across 41 states. This has resulted in 1,356 confirmed cases.
Most cases (about 92%) occur in unvaccinated individuals or those with unknown vaccination status, with children under 20 years especially affected but adults also representing a significant portion of cases.
Texas initially reported more than 700 cases, but more recent case increases have come from smaller outbreaks in other states, indicating that the outbreak is no longer concentrated only in Texas. This shifting geographic pattern explains why CDC data can show fewer new outbreak-related cases in Texas while overall US measles cases continue to climb due to spread and importations elsewhere.
The start of the school year in the US poses new threats for the spread of measles amid a record-breaking year for cases. Holding vaccine clinics at schools can increase vaccination coverage and help prevent outbreaks. School nurses and trusted community leaders can encourage and promote vaccination at the start of the school year.
Declining vaccination rates across the US have raised concerns, with only 84.8% of kindergartners in Wisconsin having gotten the two recommended doses of the MMR vaccine last school year, which is below the 95% threshold necessary to prevent an outbreak.
Some states, like Wisconsin, allow parents to exempt their schoolchildren from required vaccines for personal conviction reasons, religious beliefs, or medical reasons. However, organizations such as the American Academy of Pediatrics have reaffirmed their stance that non-medical exemptions to school immunization requirements should be eliminated.
As of Saturday, Wisconsin reported nine new measles cases, while Wyoming reported four new cases, bringing the state's total to seven. At least 89 confirmed measles cases have been reported in the US since the start of July.
It's important to note that outbreaks that start in communities with low vaccination coverage have the potential to spread beyond those communities. Currently, only 10 states remain at zero cases reported this year.
The US saw a record rate of exemptions in incoming kindergartners last school year, with about 3.6% allowed to miss at least one required vaccine. In Wisconsin, the exemption rate was more than double that, at 7.6%.
In conclusion, the measles resurgence in the US is a nationwide phenomenon fueled by decreased vaccination coverage, high contagiousness, and multiple outbreaks in various states beyond Texas. The large initial Texas outbreak is only part of the overall picture. It's crucial to prioritize vaccination to protect public health and prevent further spread of measles.
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