JONATHAN M. METSCH, Dr.P.H. – Tracking Emerging Public Health Challenges – October 24, 2026– MEASLES
““It’s been a long time, and for many of us in the United States, and in fact, throughout the Western Hemisphere, we have been able to forget how nasty measles is,” Ferrari told Al Jazeera.
Pennsylvania has been hit especially hard in the most recent outbreak. In September, the state sought emergency support from the CDC to control the spread, even as state and federal health officials quarrelled over the measles-associated death tally — differing over how deaths should be classified. State officials have recorded more than 1,200 cases and over 240 hospitalisations in 42 counties so far this year.
This spike in cases has raised concerns in neighbouring US states. On October 5, New York Governor Kathy Hochul declared a state disaster emergency in response to rising cases in rural areas, expanding the number of health professionals authorised to vaccinate and test people for measles.
“No one should get seriously ill or die from a vaccine-preventable disease,” Hochul said.
But experts warn that the risks extend far beyond US state borders. The US resurgence comes as measles cases increase globally, particularly in communities that are vaccine-sceptical or where there are gaps in healthcare access.” (1)
US officially doubles last year’s measles numbers, https://thehill.com/newsletters/healthcare/6169627-us-officially-doubles-last-years-measles-numbers/
“An ongoing measles outbreak in Pennsylvania has quickly become the largest and deadliest in the United States in more than 30 years.
Historical data suggests that 1 to 3 people will die out of every 1,000 unvaccinated people who contract measles. But Pennsylvania has reported five measles-associated deaths — with a sixth under review — out of about 1,300 total reported cases since the start of the outbreak in April.
This puts the measles death rate in Pennsylvania at least 1.5 times higher than average — and possibly up to 5 times higher.
It’s not likely that the measles virus has changed. One factor might be the size of the outbreak and a probable undercount of cases: It’s difficult to know how many people have been affected. It may also be the unique vulnerabilities of the Pennsylvania community where measles is raging.
“There clearly is a shift — not in the biology but a shift in the epidemiology that we’re seeing here in Pennsylvania,” said Dr. Matthew Ferrari, director of the Center for Infectious Disease Dynamics at Penn State University.
Experts say the outbreak is even larger than official data suggests, and it’s not clear how big it is. The US successfully eliminated measles decades ago, making it difficult to estimate how bad the current resurgence has gotten.” (2)
“The Pennsylvania health department issued a warning to doctors Monday about an increase in measles cases during pregnancy, along with rising concern about congenital measles, a disease rarely seen in the U.S.
The department’s alert said congenital measles — a measles infection in a newborn contracted from the mother — was identified “for the first time in decades.”
There are more than 1,200 measles cases in Pennsylvania, and the health department has confirmed five deaths, though a sixth death was reported earlier this month in Franklin County.
Few pediatricians have treated a newborn with congenital measles, presenting a clinical challenge for physicians.
In response to rising cases, the American Academy of Pediatrics (AAP) added a “frequently asked questions” page about congenital measles to its website in September.
According to the AAP, an estimated 25 percent to 30 percent of babies with mothers who have a measles infection at birth are also infected. Only measles infections that occur in the last two weeks of pregnancy or the first 10 days postdelivery are considered congenital.
Congenital measles was uncommon in the U.S. before the measles vaccine was introduced in the early 1960s because most women had been infected as children. But as vaccination rates plummet and measles outbreaks become more common, congenital measles is making a comeback.” (3)
Geisinger issues a measles-exposure alert for two facilities in Pa., https://www.pennlive.com/news/2026/10/geisinger-issues-a-measles-exposure-alert-for-two-facilities-in-pa.html
Penn State Health notifies public of potential measles exposures in Hershey and Lancaster, https://pennstatehealthnews.org/2026/10/penn-state-health-notifies-public-of-potential-measles-exposures-in-hershey-and-lancaster/
Hospital steps up screening as measles cluster widens in central Minnesota, https://www.startribune.com/hospital-steps-up-screening-as-measles-cluster-widens-in-central-minnesota/601903951
“California and Washington asked the US Centers for Disease Control and Prevention (CDC) in May to validate a new way to test for measles – but after waiting two months, the CDC denied the request, citing “other competing priorities”, according to a letter from the West Coast Health Alliance to the CDC director, Erica Schwartz.
The letter, signed by health officials in California, Hawaii, Oregon and Washington, asks Schwartz to reconsider and validate a rapid, high-volume measles test in preparation for major outbreaks. The alliance also asked the CDC to create protocols to test for other high-priority pathogens to prepare for future outbreaks.
The CDC is “ensuring state and local health departments have the support needed to strengthen measles detection and outbreak response”, said Emily Hilliard, a spokesperson for the US Department of Health and Human Services (HHS). The agency was “prioritizing emerging technologies” to respond to the measles outbreak, Hilliard said.
The spokesperson did not answer questions about whether the CDC had plans to validate a high-throughput measles test or assay.
Such a test would “dramatically strengthen” the ability of laboratories to respond quickly to outbreaks, the health officials said – which would help preparedness for known pathogens like Ebola or hantavirus as well as emerging threats.
Right now, laboratories have to rely on lower-volume tests for measles, like individual polymerase chain reaction (PCR) tests.” (4)
1.Why a measles outbreak in Pennsylvania poses risks beyond US borders, By Catherine Nouhan, https://www.aljazeera.com/news/2026/10/22/why-measles-outbreak-in-pennsylvania-poses-risks-beyond-us-borders
2.One US measles outbreak is proving particularly deadly. Here’s why, By Deidre McPhillips, https://www.cnn.com/2026/10/21/health/measles-pennsylvania-undercount-cdc?cid=ios_app
3.Pennsylvania warns doctors about rising rates of rare congenital measles, by Nathaniel Weixel, https://thehill.com/policy/healthcare/6162533-pennsylvania-congenital-measles-outbreak/
4.CDC denies approval for high-volume measles test, citing ‘other priorities’, by Melody Schreiber, https://www.theguardian.com/us-news/2026/oct/22/cdc-measles-test-denied
curated by Jonathan M. Metsch, Dr.P.H.
Clinical Professor of Environmental Medicine, Icahn School of Medicine at Mount Sinai