U.S. Measles Elimination Status Under Review as Fall Virus Activity Rises

A panel of eight independent experts is meeting this week to advise the Pan American Health Organization on whether the United States should lose its measles elimination status, a designation that would indicate continuous domestic transmission for 12 months. The review follows a West Texas outbreak that began on Jan. 20, 2025, and a related case in Mexico. The panel will consider epidemiologic investigations, whole-genome sequencing of virus samples, vaccination coverage, and the effectiveness of surveillance and response efforts. A decision is expected by Nov. 16.

Current surveillance data show that influenza-like illness (ILI) rates are climbing, with a national rate of 2.8%—just below the 2.9% threshold that marks the start of the respiratory season. The South and West regions are already above that level at 3.3%, and children are being affected most heavily. Flu test positivity is about 9% nationwide, and hospitalizations are rising across all regions except one. The CDC has reported three flu-associated child deaths so far in the 2026-2027 season.

COVID-19 wastewater levels remain moderate nationwide, an atypical pattern for the post-summer period, while RSV hospitalizations are increasing, particularly among children under five, with the South leading the seasonal rise.

The CDC has not yet released fall vaccination coverage data, which is usually published in September or October. Public health officials note that timely vaccination data is essential for hospitals to anticipate patient surges and for health departments to target outreach in under-immunized neighborhoods.

Separately, CDC estimates indicate that overdose deaths in the year ending March 2026 fell to about 68,000, roughly 9,500 fewer than the previous year, although some counties reported increases. The World Health Organization certified Barbados for eliminating mother-to-child HIV transmission, and a JAMA Internal Medicine study found that RSV vaccination reduced hospitalizations by 73% and deaths by 56% among Medicare nursing-home residents.

"The core question is whether the same strain of measles kept spreading for 12 months without a break," the panel’s confidential briefing notes state.

Public health experts caution that a loss of elimination status would be largely symbolic but would signal ongoing transmission in under-vaccinated communities and could lead to higher medical costs and school disruptions. They emphasize that restoring elimination would require sustained vaccination efforts and targeted outbreak response.