AUSTIN, Texas — The United States is at risk of losing its measles-free status next year as linked outbreaks across several states continue to expand, raising alarms among scientists who warn the country could return to an era of routine hospitalizations, hearing loss, and preventable deaths. Researchers estimate even small outbreaks cost public health systems hundreds of thousands of dollars, while a large outbreak like the one in West Texas this year — with 762 cases and 99 hospitalizations — can exceed $12 million in response and treatment costs.
Whether the U.S. loses its measles-free designation hinges on genomic evidence showing whether outbreaks in Texas, Utah, and Arizona stem from one continuous chain of transmission. Experts at the Centers for Disease Control and Prevention and state health departments are sequencing measles viruses to determine whether they represent one large outbreak or separate introductions from abroad. The D8-9171 strain driving U.S. cases is also circulating widely in Canada and Mexico, complicating efforts to determine its origin.
Scientists say federal response efforts have been weakened under Health and Human Services Secretary Robert F. Kennedy Jr., who has questioned vaccine safety and removed several CDC vaccine advisers. Researchers report that public health teams struggled to secure federal support during the worsening Texas outbreak, even as wastewater surveillance and genetic analyses showed the virus had likely spread undetected for weeks.
The Pan American Health Organization will review U.S. genomic data early next year and decide whether ongoing transmission meets the threshold for revoking measles-elimination status. If so, the U.S. would join Canada, which lost its status in November after failing to prove multiple outbreaks of the same strain were unrelated.
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