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Global Measles Surge in 2025
Context:
Measles, once declared eliminated in the United States in 2000, is making a troubling global comeback. As of 2025, outbreaks are being reported across the U.S., Canada, Mexico, South America, and Europe, sparking urgent concerns from health officials and infectious disease experts.
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- In both North and South America, measles cases are 11 times higher than they were during the same period last year.
- Europe is also experiencing a resurgence, with measles rates now at their highest point in 25 years.
- The European Centre for Disease Prevention and Control reported a tenfold rise in measles cases in 2024, totalling 35,212 cases.
Understanding the Contagion and the Fight Against Measles
- Measles is a highly contagious viral infection — far more contagious than influenza or COVID-19. A single person with measles can infect 12 to 18 others, compared to the R0 (basic reproduction number) of 1 to 4 for the flu and 2 to 5 for COVID-19.
- The U.S. began systematically tracking measles in 1912 when 3 to 4 million cases and about 6,000 deaths occurred annually.
- The first measles vaccine became widely available in 1963, and the current MMR vaccine (measles, mumps, and rubella) was introduced in 1971.
- By 1977, the National Childhood Immunisation Initiative aimed to ensure all schoolchildren were vaccinated. Vaccination rates rose to 96% by 1981, and in 1993, the Vaccines for Children program began offering free vaccines to those in need.
- These efforts culminated in the elimination of measles in the U.S. by 2000.
- From 2000 to 2010, U.S. cases remained under 100 per year, rising slightly afterwards due to localised outbreaks in unvaccinated communities, typically totalling 200 to 300 cases annually.
- The last major outbreak before 2025 occurred in 2019, with 1,274 cases, primarily in New York and New Jersey.
Why the Recent Surge Is Deeply Concerning?
- Unlike bacterial infections, viral infections like measles cannot be treated with antibiotics, making prevention via vaccination essential. The MMR vaccine is highly effective — one dose typically provides protection, and a second dose offers long-term immunity.
- However, measles is so contagious that at least 95% of the population must be vaccinated to maintain herd immunity. Over the past two decades, and especially during the COVID-19 pandemic, global vaccination rates have declined, primarily due to limited healthcare access and rising vaccine hesitancy.
- These factors have contributed to the current measles surge, prompting fears that the virus could become endemic again — meaning consistently present within the population — much like the common cold or COVID-19.
Projections for the Future
- Currently, Texas is experiencing a measles epidemic. If this trend continues, measles could become endemic in the U.S., similar to how COVID-19 is now consistently present.
- A 2022 modelling study predicted that if pandemic-era disruptions in vaccination are not addressed and vaccine hesitancy persists, about 15 million U.S. children (21%) could be vulnerable to measles over the next five years — well below the threshold needed to prevent outbreaks.
- A follow-up study in April 2025 projected that if current vaccination trends continue:
- The U.S. could see 850,000 measles cases over the next 25 years.
- If vaccination rates decline further, this number could rise to 11 million cases.
What Will It Take to Reverse the Trend?
- Public health experts emphasise that the key to halting this resurgence lies in increasing vaccination coverage:
- A 5% increase in community vaccination rates could dramatically reduce future cases to between 3,000 and 19,000 over 25 years.
- A February 2025 study using epidemiological models showed that early intervention in outbreaks, combined with at least 85% vaccination coverage, can effectively contain spread.
- To achieve this, the public health community must focus on:
- Ensuring universal access to free and convenient childhood vaccinations.
- Rebuilding public trust in vaccine safety and efficacy.
What Is Measles?
- Measles is caused by the measles virus, also known as the rubeola virus.
- Measles is a highly contagious viral disease that can lead to serious health complications, especially in children under 5 years old. While some people think of it as just a rash and fever, measles can cause severe illness and even death.
- The virus spreads through the air when an infected person coughs or sneezes.
- Measles symptoms generally appear 7 to 14 days after exposure to the virus. They typically include: High fever (may exceed 104° F), Cough, Runny nose (coryza), Red, watery eyes (conjunctivitis), and Rash (typically starting on the face and spreading downward).
- Measles can lead to serious complications, especially in young children:
- Ear infections and diarrhoea are common mild complications.
- Pneumonia (lung infection) and encephalitis (brain inflammation) are more severe and can be life-threatening.
- Pregnant women who get measles may also face complications, such as preterm labour.
- The best protection against measles is the MMR (Measles, Mumps, and Rubella) vaccine. The vaccine is safe and effective, with two doses being about 97% effective at preventing measles. A single dose is about 93% effective.
