A year after a meals outbreak was reported in West Texas, the United States could lose its designation as a country free of the disease, according to international health authorities. The Pan American Health Organization (PAHO) plans to meet in April to assess whether the elimination of the virus has been maintained in the country. The outbreak in Texas, which began on January 20, 2025, primarily affected rural Gaines County, where 762 cases were confirmed and two children died. Since then, authorities have detected new infections in Utah, Arizona, South Carolina, and other states, raising concerns about the continued transmission of the virus. "It's really a semantic issue. The conditions allow measles cases to occur, and that diminishes the perceived importance of the vaccine," said Dr. Jonathan Temte, a Wisconsin general practitioner who helped certify the United States as measles-free in 2000. South Carolina Cases on the Rise: The Centers for Disease Control and Prevention (CDC) reported 2,144 measles cases in 44 states during 2025, the highest number since 1991, including nearly 50 separate outbreaks. In South Carolina, confirmed cases have risen to 646 since the outbreak began in the fall. Experts attribute the increase in infections to declining vaccination coverage in some communities, parental exemptions, problems accessing healthcare, and vaccine misinformation. Furthermore, experts warn that recent conflicting messages from government officials have raised concerns about vaccine safety. Measles is highly contagious: it infects nine out of ten unvaccinated people who come into contact with the virus. A 95% vaccination rate is required to achieve herd immunity, while the current national average is 92.5%.

Cases also in Canada and Mexico

Outbreak tracing and genetic research show that the same strain of the virus has been detected in Texas, New Mexico, Utah, Arizona, South Carolina, Canada, and Mexico. However, data gaps and the difficulty in tracing transmission chains complicate the assessment of elimination status.

“My best guess is that we will lose elimination status.The arguments for ruling out ongoing transmission are weak," said Dr. Andrew Pavia, a consultant for the CDC in Utah.

In addition to the United States, Mexico is also under review by the PAHO. The country's largest outbreak is linked to the initial case in Texas and has affected more than 6,000 people, with 21 deaths in Chihuahua.

Despite the efforts of the authorities, outbreaks continue.

More than 800 cases have been reported. since late summer in Utah, Arizona, and South Carolina, with no end in sight. “2025 was the year of meals. "Now the question is whether 2026 will see an increase or a control of cases," warned Noel Brewer, a behavioral scientist and chair of the committee that collects data for the Pan American Health Organization (PAHO). The outbreak highlights the country's vulnerability to preventable diseases and underscores the need to strengthen vaccination, especially in communities with low coverage and a high risk of transmission.