The United States is on the verge of losing its measles elimination status, a designation it has held since 2000, as an international panel of health experts meets in Washington this week to decide whether the virus is once again spreading without interruption inside the country.
The Pan American Health Organization’s Regional Verification Commission began its annual meeting on Tuesday, November 10, and will continue through Friday, November 13. The panel of eight independent specialists in epidemiology, virology, pediatrics, public health and immunization is reviewing reports from all 35 member states in the Americas, with close attention to countries where outbreaks have lasted for months. Its recommendation will go to PAHO Director Jarbas Barbosa, who makes the final decision on whether the United States keeps its measles elimination status. A public announcement is expected early next week, possibly by November 17.
Few people who follow public health expect good news for the United States. The country has recorded 5,182 confirmed measles cases in 2026, according to the Centers for Disease Control and Prevention, the highest annual total since 1991, when 9,643 cases were reported. The cases have spread across 45 states and Washington, DC, and eight people have died of measles this year, more than in any year in over three decades.
How measles elimination status is decided
Elimination does not mean a country has zero cases. Under the definitions used by the World Health Organization and PAHO, a country has eliminated measles when it shows no continuous spread of the virus for 12 months or longer, backed by a surveillance system that can detect cases. A country loses measles elimination status when genetic testing shows the same strain of the virus has kept spreading inside its borders for at least a year.
For the United States, that test turns on a chain of transmission that began with an outbreak in West Texas. The first known case in that outbreak developed the telltale rash on January 20, 2025, according to state health department data, and the outbreak spread from there through undervaccinated communities. Public and independent genomic analyses have linked several ongoing transmission chains to the Texas outbreak, and chains in states such as Utah and Arizona appear to have lasted for a year or longer.
The review was first scheduled as a special session in April 2026, but PAHO postponed it to November so that officials could finish technical work, including full viral genome sequencing. Johns Hopkins epidemiologist William Moss said staffing and funding shortages at the CDC’s measles laboratory slowed that work. The panel met behind closed doors and does not announce a ruling on measles elimination status on its own.
Measles cases reach a 35-year high
The CDC’s most recent weekly update, published November 6, put the national case count at 5,182 confirmed cases. That total passed 5,000 for the first time since 1991, and it is the number that puts measles elimination status at risk. The virus is one of the most contagious known to medicine, infecting 9 out of every 10 unvaccinated people exposed to it. Community protection takes a vaccination rate of 95 percent. The current rate nationally is 92.5 percent, according to CDC data, and many communities fall far below that level.
Losing measles elimination status would put the United States alongside Canada, which lost its measles-free designation last November, and with it the entire Americas region lost its measles-free label. The Americas became the first region in the world to eliminate endemic measles transmission in 2016. PAHO reported 57,666 confirmed measles cases across 17 countries and territories in the Americas between January and October 2026.
What losing measles elimination status would change
A decision to strip the United States of its measles elimination status would not change how federal health officials handle outbreaks, CDC Director Erica Schwartz said this week. She said the agency would keep doing the same work it is doing now, working with state and local health departments on contact tracing, testing and vaccination campaigns. The loss would sharpen public messaging and push local vaccination drives, according to health officials who follow the review.
Mexico faces the same review. Mexico did not achieve measles elimination status until 2016, and more than 20,500 confirmed cases have been reported there this year, with 50 measles-related deaths, most of them children younger than 5. Guatemala is also under review, and Peru and Bolivia are on the watch list. To earn the status back, a country must go at least 12 months without continuous spread of the virus.