RESOLVING THE LEDGER
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The latest US data show measles cases from January to mid-July 2026 totaled more than all cases in 2025. Experts blame a fall in vaccination and warn that people have forgotten measles can be life-threatening.
https://p.dw.com/p/5HiUO Advertisement Behind the familiar symptoms of fever and spots is an extremely contagious virus that can cause lasting harm or death. That's the reality of measles.
But many people in the US appear to have forgotten the seriousness of a measles infection, with outbreaks mainly in under-vaccinated communities.
In fact, infections have hit a 35-year high as declining vaccination rates have created growing pockets of susceptible people.
Experts warn that the fading memories of the once-common disease have left too many people unaware of its dangers.
The number of measles cases in the United States up to mid-July 2026 surpassed the total number of cases in 2025. By the week of July 13-19, 2026, the number of reported measles cases was 2,321. By comparison, the total number of US measles cases in 2025 was 2,286, according to the US Measles Tracker run by the Johns Hopkins Bloomberg School of Public Health.
Johns Hopkins epidemiologist William Moss expects the surge in measles cases to result in the US losing the measles-elimination status it has held since 2000 .
"The significance of reaching this milestone is that the US has not been able to stop measles virus transmission or outbreaks as it has in the past," Moss told DW.
Moss said the virus was now spreading "from one susceptible community to another within the US," rather than being limited to infections brought in from abroad.
Measles is the most contagious virus on Earth , spreading far more easily than the common cold. Nine out of 10 non-immune people exposed to the virus will become infected.
Measles spreads through virus-containing droplets released from an infected person's nose, throat and lungs when they breathe, talk or cough. The smallest particles can remain suspended in the air long after the person has left the room.
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"You just have to be in somebody's airspace within two hours of them being there," said Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia.
Crucially, people can transmit measles before realizing they are infected.
Patients typically become contagious around four days before the characteristic spots or rash appear.
The combination of airborne particles, extreme contagion and transmission before obvious symptoms allows the virus to exploit even relatively small gaps in vaccination.
In the US, about one in five people with measles are hospitalized.
One in 20 infected children develops pneumonia, while around one in 1,000 develops encephalitis , a form of brain inflammation that can cause permanent brain damage.
Between one and three of every 1,000 infected children die from respiratory or neurological complications.
"We had two unvaccinated children — a healthy little six-year-old, a healthy little eight-year-old — die of measles this past year," Offit told DW.
Both died with pneumonia. "It's like dying of suffocation," he said. "It's a terrible way to die."
Among those who survive, the harm can persist long after the fever and spots disappear.
Measles can suppress the immune system for years, erasing some of the protection it had previously developed against other viruses and bacteria.
Another delayed complication is subacute sclerosing panencephalitis, a rare but fatal degenerative brain disease that can appear up to 10 years after the original infection.
"Children get infected, they get better, they're fine," Offit said. "And then five years later, seven years later, they come in with a deterioration in handwriting skills, deterioration in personality and then they descend into a vegetative state and die."
Vaccination pushed measles out of everyday life in the US. But that success has also weakened public understanding of why vaccination is necessary .
"We've not just largely eliminated measles from our country; we've eliminated the memory of measles," Offit said.
"The most serious complications of measles are relatively rare and only become apparent when there is a large number of cases," said Moss. "Unfortunately, the increasing number of measles cases in the US will once again teach us that this is not always a harmless childhood infection."
Katelyn Jetelina, an epidemiologist who publishes a Substack newsletter called "Your Local Epidemiologist," said falling vaccination rates reflected a "general amnesia about these diseases," falsehoods on social media and a wider loss of trust in institutions.
"The outbreaks remain among under-vaccinated communities," Jetelina said. "There are unvaccinated pockets all around the nation. All it takes is a spark for this disease to spread like wildfire in those pockets."
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