JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – August 6, 2026 – MEASLES
“It was 1989, George H.W. Bush was in the White House, Madonna was on the radio and the country was in the grips of its last major measles outbreak – until today.
“People were scared to death to come to the city. I mean, schools canceled trips to the city. We were pulling one dead child out of the house after another,” pediatrician Dr. Paul Offit, an infectious disease expert at the Children’s Hospital of Philadelphia who was working in the city as cases exploded, told The Independent.
By the time the outbreak ended in 1991, there had been 55,467 cases and 166 deaths across the country, Centers for Disease Control and Prevention records show.
It was the worst outbreak the country had seen since the measles vaccine, which also targeted preventable illnesses mumps and rubella, was introduced in 1963. Public health officials blamed the crisis on low vaccine coverage.
Now – with more than 2,300 cases of the potentially-deadly disease in the U.S. and numbers rising weekly – there are no such vaccine barriers. But different obstacles exist: beginning with the White House.” (1)
“Federal health officials just reported more than 50 new measles cases as of the last day of July and 2,371 nationwide, according to new data from the Centers for Disease Control and Prevention.
Active outbreaks of the highly infectious, brain-swelling disease are continuing in Ohio, Utah, Virginia and Pennsylvania, which has seen more cases reported in a week than at any time in the past decade in the state, according to The Pittsburgh Post-Gazette.
Doctors say they’re concerned about what effect kids starting school could have on the state’s outbreak.
Measles is at its highest level in the US in decades, with more cases reported within the last week. A new school year could raise risk, experts stress
“A virus that’s as infectious and easily transmittable as measles is going to take off,” Andrew Lutzkanin, a doctor at Penn State Health, told the paper.
Utah experts say they are similarly troubled.
“It’s still here, it’s still transmitting,” Utah state epidemiologist Leisha Nolenhe told The Associated Press in June. “We just need those few cases to hit the wrong community and it could flare up really big again.”” (2)
“Robert F Kennedy Jr, the US health secretary, on Sunday told American parents that they should get their children vaccinated against measles, as the surge in infections has reached numbers not seen in the past 35 years.
Kennedy, a leading vaccination skeptic who has spent years amplifying misinformation about vaccines, including the shot that protects against measles, mumps and rubella (MMR), made his call in the course of a contentious interview with CNN’s State of the Union on Sunday morning.
His remark came as the incidence of measles crossed a milestone – the US has now officially recorded 2,371 confirmed infections so far this year, surpassing 2025’s total tally of 2,289.
Taken together, the past two years have seen more measles infections in the US than the rest of the 21st century combined. The last time a greater number of measles cases were recorded in a single year was in 1991.” (3)
“The overall cost of containing a 2025 measles outbreak in New Mexico was nearly $5.4 million, a new study estimates.
The figure includes expenses for medical care, public health services and lost productivity, not just for the 57 adult patients and for caregivers of the 43 infected children but also for 205 exposed and quarantined contacts and 133 public health responders.
The total breaks down to an average of more than $53,000 for each of the 100 confirmed cases in the outbreak, according to researchers from the New Mexico Department of Health and the Centers for Disease Control and Prevention.
The outbreak began in an undervaccinated community in Texas in January 2025 and spread across the state line into New Mexico in February, first appearing in border areas. The CDC declared the outbreak over in September 2025.
So far in 2026, the United States has confirmed more than 2,300 measles infections, surpassing the 2025 tally to reach the highest annual total in 35 years amid declining vaccination rates.
In the 2025 New Mexico outbreak, public health response efforts accounted for roughly $3.2 million, with vaccination-related activities accounting for about $2.1 million of the total, the researchers reported on Monday in Annals of Internal Medicine, opens new tab.
Direct medical costs totaled $290,000, including $238,000 for seven hospitalizations, $32,000 for 79 outpatient visits and $20,000 for 1,286 commercial laboratory tests, they calculated.
Productivity loss estimates from missed work for adult patients, adult caregivers of patients under age 15, adult contacts of infected individuals and one patient who died totaled nearly $1.6 million.
The researchers said that costs might not have been accurately estimated, and some expenses were unavailable, such as over-the-counter medications and travel expenses for care.” (4)
“A new website will track the spread of vaccine-preventable diseases across the United States to offer the public, the media, healthcare providers, public health officials, and policymakers reliable and visual information about current disease trends.
The U.S. Disease Tracker, created and run by Johns Hopkins University, the Association of State and Territorial Health Officials, and the Council of State and Territorial Epidemiologists, in partnership with state and territorial public health agencies, will initially monitor cases of measles, meningitis, and pertussis (whooping cough), and later be expanded to include other vaccine-preventable diseases.
This tool monitors select vaccine-preventable diseases, such as measles, meningitis, and whooping cough, across the United States
The tracker builds on and complements the Centers for Disease Control and Prevention’s national disease surveillance infrastructure by providing open access data that is timely, detailed, and designed for broad audiences.
“The COVID-19 pandemic elucidated both the value of timely and accessible public health data, as well as the importance of data standardization,” said project co-lead Lauren Gardner, director of Johns Hopkins’ Center for Systems Science and Engineering, an expert in using data and modeling to better understand the spread of disease. “What makes this tracker unique is its foundation in standardized and validated public health data. The partnership enables a more complete and epidemiologically meaningful view of disease activity and transmission patterns, and a more reliable resource for public health professionals, policymakers, researchers, and the public.”
The tracker presents and displays data in a standardized format that is comparable across the participating jurisdictions, enabling more accurate and uniform representation of national disease trends.” (5)
“In the 9th century, a Persian doctor published one of the first written accounts of measles disease.
Widespread use of measles vaccine drastically reduced the disease rates in the 20th century.
The United States has maintained measles elimination status for over 20 years.”
“Francis Home, a Scottish physician, demonstrated in 1757 that measles is caused by an infectious agent in the blood of patients.
In 1912, measles became a nationally notifiable disease in the United States, requiring U.S. healthcare providers and laboratories to report all diagnosed cases. In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year.
A vaccine became available in 1963. In the decade before, nearly all children got measles by the time they were 15 years old. It is estimated 3 to 4 million people in the United States were infected each year. Among reported measles cases each year, an estimated:
400 to 500 people died
48,000 were hospitalized
1,000 suffered encephalitis (swelling of the brain) (6)
“Elimination of measles in the United States in 2000 was a landmark public health achievement. Twenty-five years later, the country has already reported more cases this year than it did in all of 2025, a stark reminder that public health victories can be reversed.
In mid-August, colleagues and I will review the evidence and decide whether the U.S. has maintained measles elimination. In many ways, our roles bookend that history. Several of these colleagues helped lead the national effort that ended endemic measles transmission in 2000. And I now chair the committee that must determine whether that hard‑won status still holds — or whether the country is on the verge of losing it.
To independently certify the CDC’s annual report on measles elimination, the U.S. maintains the United States of America National Verification Committee for the Elimination of Measles, Rubella, and Congenital Rubella Syndrome. (Yes, it’s a mouthful.) After our committee’s review, we will forward the report and our expert opinion to the Regional Verification Commission of the Pan American Health Organization (PAHO). Then, in November, this PAHO committee will announce whether the U.S. has maintained measles elimination.” (7)
1.A Very different kind of problem – and a dangerous one’: Doctors’ dire warnings as RFK Jr’s agenda sees measles surge back, by Julia Musto, https://www.independent.co.uk/news/health/measles-outbreak-vaccines-rfk-jr-trump-b3026600.html
2.Measles is surging in US under RFK Jr.’s anti-vax leadership — just in time for a new school, by Julia Musto, https://www.independent.co.uk/news/world/americas/us-measles-cases-rfk-cnn-outbreaks-b3026480.html
3.RFK Jr tells US families to vaccinate children against measles amid outbreak, by Ed Pilkington, https://www.theguardian.com/us-news/2026/aug/02/rfk-jr-measles-vaccination
4.A single US measles outbreak can cost millions of dollars, study estimates, By Nancy Lapid, https://www.reuters.com/legal/litigation/single-us-measles-outbreak-can-cost-millions-dollars-study-estimates-2026-08-03/
5.New U.S. Disease Tracker strengthens monitoring of vaccine-preventable diseases, By Jill Rosen, https://hub.jhu.edu/2026/08/05/us-disease-tracker-johns-hopkins/
6.History of Measles, https://www.cdc.gov/measles/about/history.html
7.What my colleagues and I will look for as we assess U.S. measles elimination status, By Noel T. Brewer, https://www.statnews.com/2026/08/06/measles-elimination-status-2026-paho/
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai