Measles Update - United States, January 1-April 17, 2025.

Abstract

A multistate measles outbreak, predominantly affecting members of close-knit communities with low measles vaccination coverage in New Mexico, Oklahoma, and Texas began in January 2025. As of April 17, a total of 800 cases have been reported in the United States in 2025; 654 (82%) cases in New Mexico, Oklahoma, and Texas have been associated with the ongoing outbreak. These cases represent an approximately 180% increase over the 285 measles cases reported in the United States during all of 2024, and the second highest annual case count in the United States in 25 years. Overall, 771 (96%) patients have been unvaccinated or had unknown vaccination status (77% were unvaccinated, and 14% had unknown vaccination status when excluding 590 cases reported by Texas, which requires explicit consent by law [i.e., opt-in] to enroll in the Texas Immunization Registry), 85 (11%) patients have been hospitalized, and three patients have died. Among 48 (6%) internationally imported cases, 44 (92%) occurred among U.S. residents. Endemic measles was declared eliminated in the United States in 2000 as a direct result of high 2-dose childhood coverage with the measles, mumps, and rubella (MMR) vaccine. However, measles cases and outbreaks continue to occur when travelers with measles return to the United States while they are infectious; larger U.S. outbreaks typically follow importation into close-knit communities with low vaccination coverage. Nationally, risk for widespread measles transmission remains low because of high population-level immunity. To prepare for and prevent measles cases and outbreaks, public health departments should continue working with trusted community messengers on culturally competent community engagement, education, vaccination efforts, and other community infection prevention approaches (e.g., case isolation, contact monitoring, and post-exposure prophylaxis) and coordinating with health care facilities and schools. Increasing national and local MMR vaccination coverage is essential to preventing measles cases and outbreaks.