The United States’ measles outbreak is far bigger than the official figures suggest, a former head of the Food and Drug Administration has warned — and the country could lose the measles elimination status it has held since 2000 as early as this month.
Key Points
- Measles cases underreported Gottlieb — former FDA chief Scott Gottlieb says the announced case count does not reflect the true size of the epidemic.
- The CDC has confirmed 5,182 cases in 2026, the highest annual total since 1991, but many cases are never counted.
- Three people died of measles in a single week: a child in New York, an unvaccinated person in Pennsylvania and an infant in Wisconsin.
- Falling childhood vaccination rates are driving the resurgence, with the US kindergarten MMR rate at 92.4%, below the 95% needed for herd immunity.
According to the CDC, 5,182 measles cases had been confirmed in the United States this year as of 5 November — more than twice the 2,289 recorded throughout 2025 and the highest number in 35 years. There have been 43 outbreaks this year, and 96% of confirmed cases were linked to them. A total of 562 people have been hospitalised.
But Scott Gottlieb, who led the FDA between 2017 and 2019, argued that the true figure is much higher. Many cases are never counted, he said, and the number announced does not reflect the true extent of the epidemic. The Johns Hopkins US measles tracker recorded 667 new cases in just the last two weeks.
Three deaths in one week
The human cost sharpened last week. A child died of measles in Lewis County, New York — the state’s first measles death in 30 years. Two days later, Pennsylvania reported the death of an unvaccinated person in Jefferson County, the second in that county. A day after that, Wisconsin reported the death of an infant, the state’s first measles death since 1990, linked to an outbreak concentrated in three southwestern counties.
The CDC itself has counted four measles-related deaths this year, but more deaths have been identified when state announcements are added together. The gap follows a policy shift under Health Secretary Robert F. Kennedy Jr.: the CDC switched to mortality data from the National Center for Health Statistics to track measles deaths, replacing its earlier reliance on state health departments’ figures, and is working with state epidemiologists on a standardised case definition.
The decline in childhood vaccination rates is cited as the main reason measles is spreading again. Wisconsin’s average childhood MMR vaccination rate is about 85%, and all 13 counties that have reported cases this year are below the 95% threshold needed for broad community protection. The state has confirmed 431 cases this year, including more than 400 since August. The measles, mumps and rubella vaccine is about 97% effective with two doses.
What happens next
If the US loses its elimination status, it would mark the end of a public-health achievement held since 2000, when domestic spread of the disease was declared stopped. Health officials are urging residents to check they are up to date with the MMR vaccine, while the CDC continues to reconcile its figures with the states. With cases still rising in November, the question is no longer whether the outbreak will worsen — it is how much worse the true count already is.
For background on the outbreak’s scale, see our report on US measles cases topping 5,000 in the worst outbreak since 1991, and on a Wisconsin infant dying of measles in the state’s first death in 36 years. More in our Health section.
Sources: Health Chosun, “U.S. Measles Cases Top 5,000 as Vaccine Hesitancy Undermines Herd Immunity and Infant Deaths Mount“; Economic Times Healthworld, “Tragic Infant Death Linked to Wisconsin Measles Outbreak as Cases Surge“.