Cases in the US continue to increase, and a new analysis shows 2024 was the highest year for measles cases in Europe in 25 years.
Captured on the 5th day of this illness, this photograph depicted a posterior view of the back of a patient with a case of measles, highlighting the characteristic erythematous rash that had manifested, and spread over this region. Note how the rash appeared to be a raised crop of irregularly shaped coalescing spots.
Image credit: CDC, Heinz F. Eichenwald, MD
A measles outbreak in 3 states continues to grow and there are a smattering of cases in various parts of the country. The Centers for Disease Control and Prevention (CDC) reports that as of last Thursday, March 13, there were 301 cases of measles in the United States including the following jurisdictions: Alaska, California, Florida, Georgia, Kentucky, Maryland, New Jersey, New Mexico, New York City, New York State, Pennsylvania, Rhode Island, Texas, Vermont, and Washington.1 CDC reports that of all the cases nationwide, 95% of individuals were considered unvaccinated or unknown, 3% had 1 MMR vaccine dose, and 2% had 2 MMR doses.1
The largest number of cases are in Texas where the state’s health department is reporting 259 cases with 34 hospitalizations, and 1 death. Of the cases, 257 of them have been classified as unvaccinated/unknown, zero cases with 1 dose of the vaccine, and 2 cases in people with 2 plus vaccines. 2
According to the state’s health officials, the unvaccinated/unknown category includes people with no documented doses of measles vaccine more than 14 days before symptom onset. 2
They also reported on existing cases, and after securing more information into the details of cases, health officials said 3 cases previously classified as vaccinated were not vaccinated cases. And 2 of those cases got their vaccine doses 1 to 2 days before their symptoms started, after they had been exposed to the virus. 2
They point out that it takes the body about 14 days after vaccination to develop immunity to measles, so people aren’t considered vaccinated until that 14-day period has passed.2
Learn more: Measles: An Old Foe Has Returned
In New Mexico, there has been 35 cases of measles in the state as of last Friday. Of those cases, 28 of them have been classified as unvaccinated, 2 cases had at least 1 dose of the vaccine, and 5 cases were in people with unknown vaccine status.3 There has been 1 death there in an unvaccinated individual.
In Oklahoma, they reported 4 probable cases of measles as of last Friday. All the individuals were unvaccinated.4
In the US cases thus far, 95% of them are in individuals with unvaccinated or unknown-status, according to the CDC.
The European numbers are also concerning, with cases doubling in 2024 compared to the previous year, and over half requiring hospitalization.
Public health officials are right to emphasize the need for urgent action to boost immunization coverage.
A new analysis by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) reported there was 127,350 measles cases in the European Region in 2024, which doubles the amount of cases reported for 2023 and the highest number since 1997.5
Children under 5 accounted for more than 40% of reported cases in the region—comprising 53 countries in Europe and central Asia. More than half of the reported cases required hospitalization. A total of 38 deaths have been reported, based on preliminary data. 5
“Measles cases across Europe and central Asia have soared over the past 2 years—pointing to gaps in immunization coverage,” Regina De Dominicis, UNICEF Regional Director for Europe and Central Asia, said in a statement. “To protect children from this deadly and debilitating disease, we need urgent government action including sustained investment in healthcare workers.” 5
The report did not offer insights on this year’s cases, but public health officials are concerned about the incidence trends.
“Measles is back, and it’s a wake-up call. Without high vaccination rates, there is no health security. As we shape our new regional health strategy for Europe and central Asia, we cannot afford to lose ground. Every country must step up efforts to reach under-vaccinated communities,” Dr Hans Henri P. Kluge, WHO Regional Director for Europe, said in a statement. “The measles virus never rests—and neither can we.” 5
