The US has confirmed 5,182 measles cases so far in 2026, the CDC said on Nov. 6, and its measles elimination status goes before an international panel next week. The Pan American Health Organization’s verification commission meets Nov. 10 to 13 and will classify each country in the Americas at the end of the meeting.
The question it has to answer is narrow: has one chain of measles spread inside the US, without a break, for 12 months or more?
The country has held the “eliminated” label since 2000. It is widely expected to lose it, CIDRAP reported on Nov. 6.
The test is one unbroken chain, not the case count
The CDC’s history page defines elimination as “the absence of the continuous spread of disease” for more than 12 months. PAHO frames the reverse in its Oct. 14 meeting notice. Endemic spread is back when one chain of the same genotype and lineage runs “uninterrupted for 12 months or longer.”
So 5,000 cases alone would not cost the US the label. Imported cases that spark short outbreaks still fit inside elimination. The CDC’s case page still says new US cases appear when someone “contracts measles abroad and returns to the country.”
The ruling sits with the Regional Verification Commission, an independent expert panel that reports to PAHO’s director.
In a March 2 update, PAHO said it would start the US clock at Jan. 20, 2025, the onset of the outbreaks under review, which began in West Texas. Mexico’s clock starts Feb. 1, 2025, and the commission takes up both countries in November.
The hard part is proving it is one chain. By January the same strain had turned up in Texas, New Mexico, Utah, Arizona, South Carolina, Canada and Mexico, AP’s Devi Shastri reported in a story carried by Yahoo News.
Sequencing alone can’t prove a link, epidemiologist Justin Lessler told AP. “Within an outbreak, everybody is going to look the same,” he said. PAHO’s Sebastian Oliel told AP that the agency leans the other way on cases of unknown origin. “The most conservative approach is to consider the case part of the existing national transmission,” he said.
From elimination to review: the timeline
We built this timeline from CDC, PAHO and state records. Where we could not open a primary record, we used reporting from the time.
| Date | What happened | Source |
|---|---|---|
| 1963 | A measles vaccine becomes available in the US. | CDC |
| 2000 | The US declares measles eliminated. | CDC |
| Oct. 1, 2018 | An outbreak begins in Rockland County, New York. | Science News |
| Oct. 3–4, 2019 | New York declares its outbreak over, and the CDC says the US kept its status. | Science News |
| Jan. 20, 2025 | Onset of the US outbreaks PAHO is reviewing. | PAHO |
| Nov. 10, 2025 | PAHO rules measles endemic again in Canada, and the Americas lose regional status. | PAHO |
| Jan. 20, 2026 | The one-year mark passes; PAHO plans an April 13 ruling, AP reports. | AP via Yahoo |
| March 2, 2026 | PAHO moves the US and Mexico review to its November annual meeting. | PAHO |
| Nov. 2–4, 2026 | New York, Pennsylvania and Wisconsin report measles deaths. | NY DOH, PA DOH, CIDRAP |
| Nov. 5, 2026 | The CDC’s count reaches 5,182 cases in 47 jurisdictions. | CDC |
| Nov. 10–13, 2026 | PAHO’s commission meets and classifies countries. | PAHO |
The 2019 near-miss is the useful comparison. New York’s outbreak had to end by Oct. 2, 2019, or the US would have lost its status, Science News reported.
That outbreak’s last case came about 10.5 months after its first. The outbreaks now under review began nearly 22 months ago.
Eight deaths by state counts, four by the CDC’s
The case count has grown every week this fall. The CDC added 330 cases in the week to Nov. 5, the 13th straight week of triple-digit growth, CIDRAP reported.
Citing CDC data, CIDRAP said 96% of this year’s cases were unvaccinated or of unknown status. About 11% of patients went to the hospital. Our Oct. 26 report has the state-by-state picture and how to check your own MMR record.
Deaths are where the federal and state numbers part. The CDC’s page lists four deaths and calls the number “subject to change.” States have reported at least eight this year, CIDRAP reported.
Pennsylvania accounts for six. On Nov. 4, the state health department confirmed its sixth, an unvaccinated Jefferson County resident. The others were in Lancaster (three), Mifflin (one) and Jefferson (one).
New York’s first measles death in about 30 years, a child in Lewis County, came on Nov. 2, as we reported.
The eighth was an infant in Wisconsin. The coroner listed measles as the immediate cause. It is Wisconsin’s first measles death since 1990, according to CIDRAP.
Wisconsin’s health department said it would not release more information about the child. “My heart is broken for the family,” Health Services Secretary Kirsten Johnson said, as quoted by CIDRAP.
What a ruling against the US would change
Mostly, the label. AP described the review as largely symbolic, and none of the PAHO statements we read attach a penalty to it. “It is really a question of semantics,” Jonathan Temte told AP. The real issue, he said, is the conditions that let so many cases happen.
Canada’s experience shows the knock-on effect. When PAHO ruled on Nov. 10, 2025, the whole region lost its measles-free status.
“When one country loses verification, the region loses it as a whole,” PAHO Director Jarbas Barbosa said that day. The other 34 countries kept their own status.
Federal officials have played the stakes down. Asked in January whether losing elimination would matter, the CDC’s principal deputy director, Ralph Abraham, said “Not really,” NBC News reported.
AP reported that he called it the “cost of doing business” globally. An HHS spokesperson told AP that Secretary Robert F. Kennedy Jr. had emphasized vaccines as the best way to prevent measles.
A ruling would also make the CDC’s own description of how measles reaches the US out of date. The disease would count as circulating at home again, not arriving from abroad.
How a country wins the label back
The way back is the same test run in reverse. A country has to interrupt the chain for at least 12 months, and the commission has to verify it. Brazil regained its status in 2024 and Venezuela in 2023 after losing it, CIDRAP noted. Barbosa tied a regional recovery to two-dose vaccination coverage of at least 95%.
Canada is still the only country in the Americas classified as endemic, PAHO’s October notice says. CIDRAP traces its outbreak to an October 2024 wedding in New Brunswick.
The commission classifies countries when its meeting ends on Nov. 13 and sends its conclusions to Barbosa. PAHO says a final report will follow.