Measles cases in the United States have reached a 35-year high, marking a concerning resurgence of the disease. This alarming trend is not just a one-year blip but a continuation of a disturbing pattern. In 2026, the country has already recorded more cases than in any other year since 1991, surpassing the grim milestone set just last year. The situation is particularly dire as measles was declared eliminated in the US in 2000, yet the past 18 months have seen more cases than the previous 25 years combined.
This resurgence is not isolated to a single state or region. Dozens of new cases are reported weekly by the US Centers for Disease Control and Prevention, with large outbreaks emerging and persisting since last year. The disease disproportionately affects children, and nearly all cases are among the unvaccinated. The situation has become a public health crisis, with Dr. Andrew Racine, president of the American Academy of Pediatrics, describing it as a "public health failure" that is "avoidable" and "unacceptable" in a country with a robust healthcare system.
One of the most concerning outbreaks occurred in South Carolina, where an outbreak in Spartanburg County became the largest in decades, with nearly 1,000 cases. The epicenter of this outbreak was the Rev. Scott Neely’s Unitarian Universalist Church of Spartanburg, where a measles-positive individual attended a Christmas brunch, potentially exposing dozens of people. This incident highlights the stark reality of a segmented society, where an outbreak can garner national attention in one's immediate vicinity but have minimal impact on daily life.
The response to measles outbreaks has become a widespread challenge. Multiple outbreaks that started in 2025 continued into 2026, and new exposures have led to large outbreaks affecting most regions of the country. South Carolina has reported the most cases in 2026, with the outbreak in Spartanburg County being a significant contributor. The situation is so dire that the state health department had to reach out to the church to trace contacts, but the lack of a comprehensive list of attendees complicated the effort.
The impact of these outbreaks extends beyond the immediate cases. The work needed to respond to even one measles case can last for weeks or months, as public health experts emphasize the labor-intensive nature of contact tracing and outbreak management. In San Francisco, for instance, the majority of case investigators were activated to do contact tracing interviews after just two cases in April, underscoring the resource-intensive nature of the response.
The situation in South Carolina and other states underscores the importance of vaccination rates. Experts warn that the potential for measles outbreaks remains as long as vaccination rates remain below 95%, a key immunity threshold. High overall coverage can mask pockets of low vaccination rates, leading to outbreaks. This is evident in Pennsylvania's Lancaster County, where over 100 cases have been reported this year, and none of them have received both recommended doses of the MMR vaccine.
To combat this, public health departments are implementing various strategies. In Virginia, local health workers have been actively meeting with community members, interviewing families, and working with healthcare providers to prepare for potential cases. The state has also coordinated a mobile care team that can visit community members for testing and care, lowering barriers to intervention. Additionally, the Virginia health department issued an advisory asking unvaccinated individuals to avoid large gatherings and events in outbreak areas.
The story of measles outbreaks in the US is a complex one, with a multitude of factors contributing to the resurgence. It highlights the importance of community engagement, the labor-intensive nature of public health responses, and the critical role of vaccination in preventing outbreaks. As the country grapples with this crisis, it is essential to learn from these experiences and take proactive steps to ensure that measles remains a distant memory in the future.
