TRACKING EMERGING VIRUSES – June 15, 2025 – MEASLES
“If we’re losing ground on measles, we may soon be vulnerable to other vaccine-preventable diseases. Whooping cough cases are already rising. Polio, Hib, or even diphtheria may soon appear in our emergency rooms. Unlike most of human history, childhood deaths from infectious diseases are now relatively rare (at least in high-income countries like the U.S.), and we’d like to keep it that way.
For people working in public health departments, this outbreak is revealing the cracks in our fragile public health system, cracks that are only going to get bigger as resources and personnel are actively being defunded. Local health departments—understaffed and underfunded—are scrambling to contain something that should have been preventable. Many are still recovering from Covid-19 burnout, and the prospect of trying to contain more outbreaks with even fewer resources is demoralizing.” (1)
“That level of contagiousness has prompted the clinic to implement new precautions. Patients scheduling appointments are now asked if their visit involves possible measles exposure or symptoms.
“If we even think someone might have measles—based on travel, exposure or early symptoms —we can activate special triage strategies to reduce any risk to other patients,” Esper said. (2)
“The resurgence of measles in the US highlights the importance of early identification to prevent outbreaks, and more medical educators are taking proactive approaches to prepare students and current clinicians for real-world management.
“Given the rising number of measles cases nationally and globally, largely driven by falling vaccination rates and pandemic-related disruptions of global migration, Rush clinicians recognized an urgent need to better prepare future clinicians,” said Nicholas Cozzi, MD, EMS medical director at Rush University Medical Center, Chicago, in an interview. “We wanted to ensure our medical students could identify classic features of measles but also recognize how rashes may appear differently across diverse skin tones,” he said. Early recognition of measles by all healthcare providers is critical to help prevent further transmission and reduce complications, he added.” (3)
“The World Health Organization sets the criteria for elimination status, requiring a country — or defined geographical area — to go at least 12 months without continuous domestic transmission of a virus. That means any new outbreaks during that time must come from people who contracted the virus from outside, not inside, the U.S.”
“Under that criteria, the U.S. has until January to eliminate the nation’s current outbreaks, which is a year after cases started domestically in Texas, according to epidemiology experts. If it doesn’t, the U.S.’s measles elimination status could be taken away.
““It could affect U.S. citizens’ ability to travel to specific countries if they don’t want the risk of measles getting introduced to their country. It could affect other people’s ability to come visit the U.S. Other countries might require proof of measles vaccination before they can reenter their home country,” she said.
There could also be increased quarantine and isolation requirements, with potential economic fallout, she said.”” (4)
“Another group also worried about measles: employers. Companies lose days of productivity when workers take off to care for sick children. Besides saving lives, this was another reason it was smart for the US government to help fund the development of an inoculation and why President John F. Kennedy signed a law expanding access to childhood vaccinations. In the decade after the measles shot arrived in 1963, the number of cases was cut in half, and according to the US surgeon general, the direct health-related savings during that time were at least $1 billion annually, adjusted for inflation. That number doesn’t account for productivity loss from overtaxed parents or the unspeakable tragedy of deceased children who could’ve grown up and contributed to society.
Not only do vaccines keep people alive and reduce long-term health complications from the diseases they prevent, but they’re also important to the economic health of a nation. Before widespread vaccinations, rich countries were poorer countries, with citizens who were sicker, less productive and more likely to die younger. Promoting vaccine use isn’t merely an ethical or public-health issue; it’s good economic policy. “Vaccines are one of the most cost-effective solutions in public health,” says Sachiko Ozawa, an associate professor at the Eshelman School of Pharmacy at the University of North Carolina at Chapel Hill.” (5)
“Until now, 2019 held the record for the highest number of measles cases since the virus was eliminated. (Before that, large outbreaks sickened tens of thousands of people in some years.) Most of the 1,274 cases that year were connected to a large outbreak that spread through Orthodox Jewish communities in New York State for nearly 12 months.
With aggressive vaccine mandates, which helped substantially increase childhood immunization rates in the area, the United States only narrowly avoided losing elimination status that year.
Public health experts worry that the country will not be able to avoid that fate this time. Local officials in West Texas have already predicted the outbreak will continue for a year.”
“Another challenge in controlling this year’s outbreak is the global rise of measles. Large outbreaks have spread through Mexico and parts of Canada, which has had a record number of cases this year. This spring, the World Health Organization announced that Europe had reported the highest number of measles cases in more than 25 years.
Dr. Michael Osterholm, an epidemiologist at the University of Minnesota, attributes this to internationally declining vaccination rates, which have created “a new world order” for the spread of measles.”
The global rise means the virus is constantly reintroduced into the country through visitors, giving it repeated opportunities to find pockets of unvaccinated Americans, he said.
“Unless we change the status of vaccination levels,” he said, “I don’t see it ending.”” (6)
“The Centers for Disease Control and Prevention on Wednesday reported that measles cases hit a 33-year record amid declining children’s vaccination rates. This is a warning about how quickly public-health progress can backslide, especially when people in authority fan public fear about the risks of vaccination.”
“Inoculation rates need to stay above 95% or so to limit the virus’s spread and protect those who can’t get vaccinated, such as infants or the immuno-compromised. In other words, refusing to be inoculated for measles can cause harm to others.
Health and Human Services Secretary Robert F. Kennedy Jr. nonetheless insists that the decision to get vaccinated is personal while he makes spurious claims that discourage people from vaccination. “There are adverse events from the vaccine. It does cause deaths every year. It causes all the illnesses that measles itself cause, encephalitis and blindness, etc., and so people ought to be able to make that choice for themselves,” he said on Fox.” (7)
“Senate Minority Leader Chuck Schumer demanded Health and Human Services Secretary Robert F. Kennedy Jr. declare a nationwide emergency over spiking measles cases, accusing him of fueling the outbreak by dismantling public health and undermining trust in vaccines.
“Under your tutelage as Secretary, you have undermined vaccines, gutted public health funding, and dismantled core federal protections meant to keep Americans safe,” Schumer wrote in a July 11 letter.
“You have walked our country into the nation’s largest measles outbreak in 33 years,” he added.” (8)
“USA Today reports measles is among the most contagious infectious diseases, so much so that that 92% of unvaccinated people who are exposed end up coming down with it. In response to the latest numbers, affected states have opened special vaccination clinics and broadened guidelines to allow infants as young as six months to get their first MMR dose. In March and April, about 20% of children who got their first measles shot in Texas did so early, prior to their first birthday.” (9)
1.It’s not just about measles, by Katelyn Jetelina and Kristen Panthagani, https://yourlocalepidemiologist.substack.com/p/its-not-just-about-measles
2.Cleveland Clinic implements new precautions amid measles spike, by Melissa Reid, https://fox8.com/news/cleveland-clinic-implements-new-precautions-amid-measles-spike/
3.Upping the Ante on Measles Education, by Heidi Splete, https://www.medscape.com/viewarticle/upping-ante-measles-education-2025a1000ion
4.Measles Cases Could Cost the U.S. Its Elimination Status. Here’s What That Means., by Nina Golgowski, https://www.huffpost.com/entry/measles-us-elimination-status_n_687148e4e4b07da2c0819b46
5.Declining Vaccine Rates Make Economies Sicker, By Mark Milian, https://www.bloomberg.com/opinion/articles/2025-07-09/measles-record-number-of-cases-could-have-been-avoided
6.Measles Cases Hit Highest Total Since U.S. Eliminated the Disease, By Teddy Rosenbluth and Jonathan Corum, https://www.nytimes.com/2025/07/09/well/us-measles-record-outbreaks.html
7.Measles, RFK Jr. and Dr. Fauci, By The Editorial Board, https://www.wsj.com/opinion/measles-cases-vaccines-cdc-rfk-jr-public-health-1fd6c7fd?gaa_at=eafs&gaa_n=ASWzDAjsOoIdGZn0sr20O1dpXLEZRa-JR7Tv8VRGhzgjAUHHEuhti0CVZae3AFBPZaw%3D&gaa_ts=687706a5&gaa_sig=0K3a4QtUdRIgvTe4HOC_kzAqiqr7mXT-Dj6_hSDXAdxtD3Ez_B0nhYMcMLyv6zVe-5KnPsnpxBxNCWH6s4hzlg%3D%3D
8.Schumer demands RFK Jr. declare measles emergency, saying he ‘walked’ US into US into outbreak, by Cybele Mayes-Osterman, https://www.usatoday.com/story/news/politics/2025/07/12/schumer-letter-rfk-jr-measles-emergency/84782033007/
9. One Figure Shows How Bad Measles Cases Are, By Kate Seamons, https://www.newser.com/story/371411/one-figure-shows-how-bad-measles-cases-are.html
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai