Measles, a contagious viral disease once considered eliminated in the United States, has made a troubling comeback in recent years. As of March 2, 2025, a significant outbreak in Texas and neighboring New Mexico has drawn national attention, with additional cases reported across multiple states.
This resurgence, coupled with a decline in vaccination rates, has raised alarms among public health experts. In this article, we explore the current outbreak, review measles statistics over the past decade, and detail the symptoms and treatments for this preventable illness.
The 2025 Measles Outbreak: Texas, New Mexico, and Beyond
The outbreak currently underway began in late January 2025 in the South Plains region of Texas, centered in Gaines County.
By February 27, 2025, Texas health officials had confirmed 124 cases, predominantly among unvaccinated children and teenagers. Tragically, on February 26, an unvaccinated school-aged child in Texas succumbed to the disease—the first measles-related death in the U.S. since 2015.
The outbreak has spilled over into eastern New Mexico, where nine cases have been reported in Lea County as of February 23, bringing the combined total to 133 cases across the two states.
Elsewhere, the U.S. Centers for Disease Control and Prevention (CDC) reported 164 confirmed measles cases across nine jurisdictions by February 27, 2025, including Alaska, California, Georgia, Kentucky, New Jersey, New Mexico, New York City, Rhode Island, and Texas.
Three distinct outbreaks—defined as three or more related cases—account for 93% of these cases (153 of 164).
Texas remains the epicenter, with health officials estimating that the true number of infections could be as high as 200 to 300 due to unreported or untested cases.
The year with the biggest measles outbreak in the United States over the last decade was 2019.
From January to October of that year, the CDC reported 1,249 confirmed cases across 22 outbreaks in 17 states, marking the highest number of cases since 1992.
The majority of these cases—89%—occurred in individuals who were unvaccinated or had unknown vaccination status, with significant outbreaks linked to Orthodox Jewish communities in New York City and New York State.
Measles Over the Last Decade: A Statistical Overview
To understand the current surge, it’s helpful to examine measles trends in the U.S. over the past 10 years.
Measles was declared eliminated in 2000, meaning no continuous transmission occurred for over a year, thanks to widespread vaccination. However, imported cases from international travelers and declining vaccination coverage have led to periodic outbreaks.
Below is a summary of annual confirmed cases from 2015 to 2024, based on CDC data, with 2025 projections based on current trends:
2015: 188 cases, including a notable outbreak linked to Disneyland in California (147 cases).
2016: 86 cases, a significant drop from the previous year.
2017: 120 cases, with an outbreak in an unvaccinated Somali community in Minnesota.
2018: 375 cases, driven by 17 outbreaks, many in under-vaccinated communities.
2019: 1,274 cases—the highest since 1992—spurred by outbreaks in New York’s Orthodox Jewish communities and other areas, threatening the U.S.’s elimination status.
2020: 13 cases, a sharp decline likely due to reduced travel during the COVID-19 pandemic.
2021: 49 cases, remaining low amid ongoing pandemic restrictions.
2022: 121 cases, signaling a gradual uptick as travel resumed.
2023: 59 cases, a modest increase but still below pre-pandemic levels.
2024: 285 cases across 33 jurisdictions, with 16 outbreaks, reflecting a significant rise linked to vaccine hesitancy and global measles activity.
As of February 27, 2025, the 164 cases reported so far this year already surpass the totals for most years in the past decade, excluding 2019 and 2018.
Research from the CDC indicates that 92% of 2025 cases (153 of 164) are outbreak-associated, and 95% of cases involve individuals who were unvaccinated or had unknown vaccination status.
This aligns with a broader trend: from 2015 to 2024, unvaccinated individuals consistently comprised the majority of cases, with vaccination coverage among kindergarteners dipping from 95.2% in 2019–2020 to 92.7% in 2023–2024—leaving approximately 280,000 children at risk.
The potential link between measles outbreaks and illegal immigration has been a topic of debate, with some suggesting that unvaccinated migrants crossing borders could contribute to the re-emergence of the disease in the United States.
According to the CDC, a notable measles outbreak in Chicago in 2024 was associated with a migrant shelter, where 57 cases were confirmed, primarily among unvaccinated individuals from Venezuela—a country with declining childhood vaccination rates (CDC, “Measles Outbreak Associated with a Migrant Shelter — Chicago, Illinois,” May 15, 2024).
Data from the CDC also indicates that, as of February 27, 2025, 164 measles cases were reported across nine U.S. jurisdictions, with 93% linked to outbreaks, some potentially tied to international travel or migrant populations (CDC, “Measles Cases and Outbreaks,” March 1, 2025).
However, experts like Daniel Salmon from Johns Hopkins have argued that most U.S. measles cases stem from unvaccinated Americans traveling abroad to outbreak zones like Europe or the Philippines, not illegal immigration (Health Feedback, May 1, 2019).
While the Chicago case suggests a possible connection in specific contexts, broader data shows that declining domestic vaccination rates—down to 92.7% among U.S. kindergartners in 2023–2024 from 95.2% in 2019–2020—play a significant role in enabling outbreaks once the virus is introduced, regardless of its origin (CDC, “Measles Cases and Outbreaks”).
Thus, while illegal immigration may contribute in isolated instances, the primary driver appears to be vaccine hesitancy within the U.S. itself.
Symptoms of Measles
Measles is caused by the measles virus, a highly contagious pathogen spread through respiratory droplets. Symptoms typically appear 10 to 14 days after exposure and progress in stages:
Initial Symptoms: A high fever (often exceeding 104°F), cough, runny nose, and red, watery eyes (conjunctivitis) mark the onset. These cold-like symptoms last 2 to 4 days.
Koplik Spots: Small white spots may appear inside the mouth 2 to 3 days after initial symptoms, a classic sign of measles.
Rash: A red, spotty rash emerges 3 to 5 days after the first symptoms, starting on the face and spreading downward to the trunk, arms, and legs. The rash typically lasts about a week.
Symptoms resolve within two to three weeks for most, but complications can arise. About 1 in 5 unvaccinated measles patients in the U.S. requires hospitalization, often for pneumonia (1 in 20 children) or encephalitis (brain swelling, 1 in 1,000 cases), which can lead to deafness, cognitive impairment, or death. Up to 3 in 1,000 infected children die from respiratory or neurological complications.
Treatments for Measles
There is no specific antiviral treatment for measles; care is largely supportive. The CDC recommends the following approaches:
Symptom Management: Rest, hydration, and fever-reducing medications like acetaminophen or ibuprofen help alleviate discomfort. Avoid aspirin in children due to the risk of Reye’s syndrome.
Complication Treatment: Bacterial infections, such as pneumonia or ear infections, are treated with antibiotics. Severe cases may require hospitalization for oxygen therapy or other interventions.
Vitamin A Supplementation: The World Health Organization and CDC recommend high-dose vitamin A for children with measles, particularly in areas with deficiency, as it can reduce severity and mortality by boosting immunity. Two doses are typically given 24 hours apart.
Post-Exposure Prophylaxis: If administered within 72 hours of exposure, the measles, mumps, and rubella (MMR) vaccine can prevent infection. For those who cannot be vaccinated (e.g., infants under 6 months or immunocompromised individuals), immune globulin within six days of exposure can offer protection.
Prevention remains the cornerstone: two doses of the MMR vaccine—administered at 12–15 months and 4–6 years—are 97% effective at preventing measles, with a single dose offering 93% protection.
Research Insights and Future Outlook
Recent studies highlight the role of vaccine hesitancy in measles resurgence.
A 2024 CDC report noted that U.S. MMR coverage has fallen below the 95% threshold needed for herd immunity in many communities, a trend exacerbated by misinformation following the COVID-19 pandemic.
Globally, the World Health Organization reported a 30% increase in measles cases from 2016 to 2019, with 2023 seeing 10.3 million infections, further increasing importation risks to the U.S.
Research from Johns Hopkins Bloomberg School of Public Health emphasizes that even small pockets of unvaccinated individuals can fuel outbreaks, given measles’ extraordinary contagiousness—capable of infecting 9 out of 10 susceptible people in close proximity.
The 2025 measles outbreak in Texas and New Mexico, alongside cases in other states, signals a troubling reversal of decades of progress. Over the past 10 years, annual case counts have fluctuated, but the current trajectory suggests 2025 could rival 2019’s record high.
This article synthesizes available data up to March 2, 2025, and reflects trends from the past decade. For real-time updates, readers should consult the CDC’s measles webpage or state health department alerts.
Ref
https://publichealth.jhu.edu/2025/what-to-know-about-measles-and-vaccines
https://www.cdc.gov/measles/data-research/index.html
https://www.cdc.gov/global-measles-vaccination/data-research/global-measles-outbreaks/index.html
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