We have known about measles since the 10th century. It was first identified by Dr. Rhazes, a Persian physician who described this illness “as more to be dreaded than smallpox.” Measles outbreaks were widespread around the world by the Middle Ages. The word measles comes in part from the Latin word for misery (misella). Before a vaccine was developed, millions of people in the U.S. caught this viral disease annually and hundreds died. But a vaccine was developed in 1963 and by 2000 the US had bragged that measles had been all but eradicated. Now, though, we are experiencing more cases of measles than we have in over three decades.
Measles Outbreaks Were Never Really Eliminated:
Although the CDC likes to claim that measles cases disappeared in 2000, the truth is that this virus never really vanished. In 2000 there were, according to the CDC, 85 measles cases. In 2004 there were only 37 cases. There was a pretty big bump in 2014 (667 cases) and another in 2019 (1,274).
During 2020, though, there were only 13 cases of measles. That is probably due in large part to COVID-19. People were hunkering down and being really careful about avoiding crowds and wearing masks. By 2024, though, cases were back up to 285 cases. You can see annual measles cases for yourself at this link.
In 2025 Measles Outbreaks Took Off!
Measles outbreaks that started in Texas and New Mexico now have public health officials worried. At last count, 38 states have recorded cases of measles.
We have received a lot of comments from readers speculating about how and where the measles cases came from. Many people blame immigrants. It would appear, however, that most of the cases in the Southwest started in a tight-knit Mennonite community in West Texas. A number of religious groups shun vaccines. That includes certain Amish and Mennonite communities. Some Ultra-Orthodox Jewish groups also avoid vaccines. And there is an anti-vaccine movement growing within some Conservative Christian groups.
Measles is highly contagious and can have serious outcomes, especially in young children. They may develop ear infections, bronchitis, pneumonia or diarrhea. About 1 in 1,000 develops encephalitis, which can result in lasting brain damage. Vision and hearing may be affected. There can also be cognitive difficulties.
Measles infections can kill; at least three Americans have died from the infection in 2025.
How Many People Have Had Measles in 2025?
Until recently, measles outbreaks were relatively rare. As mentioned, in 2000 public health authorities declared that measles had been eliminated from the United States. That announcement was clearly premature.
While the CDC has officially confirmed 1,288 cases (July 9, 2025) so far this year, we suspect the number could be higher. If the trend continues, we are likely to experience well over 2,500 measles cases before the end of the year.
Between 2000 and 2010, there were fewer than 100 cases of measles in the US each year. Texas continues to have the most cases, with more than 700.
Other states include Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, New Jersey, New Mexico, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Vermont, Virginia and Washington. Pediatricians fear that many more people have already contracted measles but have not been tested.
Other countries are also struggling against measles, with more than 3,000 cases reported this year in Canada. Mexico is also experiencing a large outbreak that started after a child caught the disease while visiting Texas.
Two doses of the measles mumps & rubella vaccine, or MMR, protects both children and adults from the infection at about 97% effectiveness.
Why Is Measles a Problem This Year?
Epidemiologists suggest that many children missed their regular vaccinations during the pandemic. Vaccine hesitancy has also reduced vaccination rates. This has brought some parts of the US well below the 95% vaccinated rate needed to provide herd immunity.
The measles virus is airborne, so it travels easily from person to person. In addition, it can linger in a room for up to two hours. That’s why one person with measles can easily spread the virus to 9 out of 10 other unvaccinated people.
On the other hand, the vaccine is highly effective. People who get the standard two doses of MMR have 97% protection. (The acronym stands for Measles, Mumps and Rubella, aka German measles). Because there is no effective treatment for measles, vaccination to prevent the disease is the best protection.
A Recent History of Measles:
Several years ago, a measles epidemic left more than 700 people sick in the U.S. Young children were hardest hit in outbreaks across the country, from New York State’s Rockland County to California’s Los Angeles County. Michigan, New Jersey, Georgia and Maryland also saw large numbers of cases. In fact, in 2019 the US had more cases of measles than it had experienced in 20 years. Unfortunately, 2019 was not the end of measles outbreaks. Measles outbreaks are becoming a worldwide problem, and epidemiologists expect more.
A Resurgence of Measles Around the Globe:
The European Society of Clinical Microbiology and Infectious Diseases met in Barcelona, Spain in 2024. At those meetings investigators revealed that global measles cases have almost doubled, from 170,000 cases in 2022 to over 320,000 cases in 2023. Health officials counted actual cases to reach those numbers, but they estimate that the true incidence is in the millions. People with cases that are not severe may not seek health care and thus may not get counted.
Vaccination rates have been falling in many countries, including the US. Measles is not a benign infection. Young children may develop pneumonia, brain swelling and severe diarrhea. An infection can kill undernourished children.
Where in the World Are Measles Outbreaks Occurring?
In 2019, Brazil, India, Madagascar, the Philippines, Ukraine and Venezuela. Israel, France, Greece and Georgia had measles outbreaks. That means international travelers probably contributed to the virus spreading around the world. As a result, the CDC is encouraging Americans traveling overseas to bring their vaccinations up to date before they leave.
What Are the Symptoms of Measles?
Measles, also called rubeola, is caused by a virus that is highly contagious. It spreads through droplets from sneezes or coughs. Within ten days to two weeks of exposure, the patient may experience a high fever, sore throat, runny nose, red, watery eyes, dry cough, headache and muscle pain.
So far, it sounds a lot like the flu or a flu-like illness. However, two to three days later tiny white spots develop on reddened areas of the inner cheek. Doctors call them Koplik spots. In addition, there is the measles rash. It often starts on the chest, back and face, but the red spots frequently spread to other parts of the body.
Measles Complications:
Measles can be a serious infection at any age, but very young children may be especially susceptible to complications. In such youngsters, ear infections associated with measles can lead to permanent hearing impairment.
The infection can also cause diarrhea in just under 10 percent of people who catch the virus. Some children (up to 5 percent) with measles come down with pneumonia as a consequence. Even more alarming, one child in 1,000 will develop swelling of the brain in reaction to the infection or the high fever. This can trigger seizures. Worst of all, measles can kill kids. About one or two children in every thousand with the infection die as a result.
What Is the Future of Measles?
Although the US was almost free of measles 25 years ago, that is no longer the case. Achieving high levels of vaccination will be crucial to stopping the current measles outbreaks. Without that, it is likely that we will face more epidemics in the future.
I admit that I am not an objective observer of this measles outbreak. I was born before there were vaccines for polio, whooping cough or measles. And yes, I caught all three of these infections. I have written about that experience at this link.
