In a closed-door session, a Pan American Health Organization advisory commission is weighing whether the United States and Mexico have lost the hard-won achievement of having stopped measles from taking root. The question turns on genetics: whether one strain of the virus has moved through North American communities continuously for a year or more since 2024. The United States had held its status for thirty years, a quiet victory built on vaccination rates that once rose above ninety-seven percent, and its loss would mark a turning in a long human story of protection that has slowly eroded thr
US, Mexico Poised to Lose Measles Elimination Status as Worst Outbreaks in Decades Continue
Mexico has reported 50 measles-related deaths, mostly children under 5, and the U.S. has recorded eight measles deaths this year.
The decision represents us moving backward.
Mark
Why does a label matter if the virus is already spreading?
Mimi
Because it's a formal finding that the spread is continuous, not a string of imported cases. Experts expect the meeting to say measles has returned to the U.S. and Mexico.
Luke
Expect, though. Nothing's been announced. The commission's work is closed-door, and the director makes the final call.
Mark
What is the commission actually looking at?
Mimi
Genetics. Whether the same virus has circulated for a year or more since the outbreaks began in 2024.
Luke
And that's Adalja's description, a physician outside PAHO. We haven't seen the data itself.
Mark
The CDC director says the designation isn't what protects people.
Mimi
She says vaccination does, and that the agency is working with local health departments where transmission is occurring.
Luke
Critics disagree about whether the response is strong enough, but that's their characterization of a muted response. What's documented is Kennedy's moves on the schedule and advisory board.
Mark
And the numbers?
Mimi
Over 5,400 U.S. cases and eight deaths this year; in Mexico over 20,500 cases and 50 deaths, mostly children under 5.
Luke
Those are confirmed counts as reported. The Chihuahua origin is what researchers think happened, not something proven.
Le Pouls
- A commission of international experts is reviewing genetic evidence that could strip the U.S. and Mexico of their measles elimination status.
- The U.S. has logged over 5,400 confirmed cases this year, double the 2025 total, with eight deaths and its worst year since 1991.
- Mexico has reported more than 20,500 cases and 50 deaths, most among children under five, after an outbreak traced to Texas and Chihuahua.
- Health leaders are sharply divided over the federal response, with some calling for a vigorous vaccination drive while officials say the designation itself does not drive protection.
- PAHO Director Jarbas Barbosa holds the final decision, with an announcement expected next week.
In a closed-door session, a Pan American Health Organization advisory commission is weighing whether the United States and Mexico have lost the hard-won achievement of having stopped measles from taking root. The question turns on genetics: whether one strain of the virus has moved through North American communities continuously for a year or more since 2024. The United States had held its status for thirty years, a quiet victory built on vaccination rates that once rose above ninety-seven percent, and its loss would mark a turning in a long human story of protection that has slowly eroded through doubt and neglect. The final judgment rests with PAHO's director, whose announcement is expected within the week.
This week, an advisory commission of the Pan American Health Organization is reviewing genetic data to decide whether the United States and Mexico have lost their measles elimination status. The question is whether the same strain has circulated continuously for a year or more across North American outbreaks since 2024. The U.S. earned its status in 2000 after vaccination campaigns pushed childhood coverage above 97 percent, but rates have slipped for years amid disproven claims linking the vaccine to autism, falling to about 92 percent last year.
The consequences are visible in the numbers. This year's more than 5,400 confirmed U.S. cases already double 2025's total, driven largely by a large Pennsylvania outbreak, and eight people have died, the most in more than three decades. Mexico's situation is graver, with over 20,500 cases and 50 deaths, most of them young children, after an outbreak that researchers trace to an unvaccinated child who traveled from Chihuahua to Texas and returned infected.
CDC Director Erica Schwartz says a loss of status would not change federal handling of outbreaks, arguing that vaccination, not the designation, protects Americans. Many public health experts disagree, calling for a stronger vaccination campaign and faulting what they see as a muted, politicized federal response. Dr. David Margolius of Cleveland put it plainly: the decision would represent moving backward. The announcement is expected next week.
This week, in a closed-door session, an advisory commission of the Pan American Health Organization is going through genetic data on measles. The question before it is whether the United States and Mexico have lost the status of having eliminated the disease, a public health achievement the U.S. held for 30 years.
The commission is looking at whether the same strain of measles virus has been spreading continuously for a year or more in the outbreaks that have run through North America since 2024. "It's solely based on genetics," said Dr. Amesh Adalja, an infectious disease physician near Pittsburgh and a senior scholar at the Johns Hopkins Center for Health Security. If the genetic evidence shows that, the commission will say sustained circulation has returned. It will present that finding to PAHO Director Dr. Jarbas Barbosa, a former Brazilian health official, who makes the final call. PAHO officials say an announcement is being scheduled for next week. Last year, the organization stripped Canada of the status it had held since 1998.
The U.S. earned elimination status in 2000, after vaccination campaigns pushed childhood measles vaccination above 97%. Health experts say about 95% coverage is needed so that when an infected traveler arrives, enough people are protected to keep an outbreak from starting. U.S. rates have slipped for years, partly because of disproven claims linking the vaccine to autism. Last year the national childhood rate fell to about 92%, and it was far lower in some states and communities. Earlier this year, President Donald Trump claimed, without evidence, that the MMR vaccine is possibly "quite lethal."
The results are visible in the case counts. Large outbreaks hit Texas, Arizona, Utah and South Carolina last year. This year's more than 5,400 confirmed cases are already double the 2025 total, driven largely by an outbreak in Pennsylvania that has dwarfed the earlier ones. Eight people have died of measles in the U.S. this year, the most in any year in more than three decades, and it is the worst year for measles illness since 1991. Over the past two years, outbreaks have caused thousands of illnesses and about a dozen deaths. Measles usually starts with a high fever and then a rash on the face and neck. Most people recover, but the World Health Organization lists it among the leading causes of death in young children, and blindness and brain swelling are more common in young children and adults over 30.
Mexico's situation is more severe. It did not reach elimination status until 2016, years after the U.S. Cases began climbing early last year. Researchers think the outbreak in the northern state of Chihuahua began when an unvaccinated Mennonite child from there traveled to Gaines County, Texas, where an outbreak was underway, and returned infected. As of this week, Mexico has reported more than 20,500 confirmed cases and 50 deaths, most of them children under 5.
The problem extends beyond North America. Early this year, the World Health Organization confirmed that Armenia, Austria, Azerbaijan, Spain, the United Kingdom and Uzbekistan had lost their status.
CDC Director Erica Schwartz said a loss of status would not change how federal officials handle outbreaks. "The measles elimination designation is not what protects Americans. Vaccination does," she said, adding that the agency knows where transmission is occurring and is working with state and local health departments to reach those communities.
Many public health experts want more than that. They say the moment calls for a vigorous vaccination campaign and more guidance for doctors, and they fault what they describe as a politically fraught, muted federal response. They blame Health Secretary Robert F. Kennedy Jr., a leading anti-vaccine voice before Trump put him in charge of the nation's health agencies. Kennedy has moved to downsize the childhood vaccine schedule, reshape a key vaccine advisory board, and praise Trump's executive order calling for spacing out the measles, mumps and rubella vaccine, which runs counter to medical groups' recommendations and, experts say, would likely leave fewer children fully vaccinated. Dr. David Margolius, Cleveland's health director and a leader in a coalition of big-city health departments, put it plainly: "It's a big deal. The decision represents us moving backward."
The announcement is expected next week.
Citations marquantes
The measles elimination designation is not what protects Americans. Vaccination does.— CDC Director Erica Schwartz
It's a big deal. The decision represents us moving backward.— Dr. David Margolius, Cleveland health department director
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