PAHO Measles Review Adjourns Friday With U.S. Elimination Status Undecided; CDC Provisional Count Is Six Deaths

Since the Pan American Health Organization's Regional Verification Commission opened its closed-door measles review in Washington on Nov. 10, no decision has been announced on whether the United States keeps the elimination status it has held since 2000. The session is scheduled to adjourn Friday, Nov. 13. The commission's findings then go to the PAHO director, who will communicate status determinations to national governments.

What the commission has to decide

PAHO's standard is specific. Endemic transmission means the same virus genotype and lineage circulating without interruption for 12 months or longer in a defined geographic area. Raw case and death counts do not decide it.

Imported cases don't count against a country either. A limited outbreak that traces to travel exposure would not cost a country its status.

Investigators use genetic sequencing to tell separate introductions from continuous local spread. They also weigh vaccination coverage, how well health systems track cases, and how fast outbreaks are contained.

PAHO told Reuters this week that the U.S. is on a watch list alongside Mexico and Bolivia. Other accounts of the review also name Guatemala and Peru as at risk. Canada lost its status in November 2025 after confirming 5,197 cases that year.

The U.S. numbers

The CDC has recorded 5,182 measles cases in 2026. That is the highest level since 1991 and compares with 85 cases in all of 2000. The U.S. has now logged nearly 7,500 cases since the start of 2025, after 2,255 confirmed infections last year.

The case count is not in dispute. The death count is.

The CDC's latest provisional figures, as of Nov. 6, show six measles deaths this year, double the three recorded in 2025. Another account puts the CDC's officially recognized 2026 total at four. Local health departments in three states report eight.

At the start of November, New York state officials said a child died after contracting measles. It was the state's first measles death in more than 30 years.

From 2000 through 2020, the U.S. recorded three measles deaths: two in 2003 and one in 2015.

A gap of two to four deaths between federal and local tallies is not a rounding issue. It means the national surveillance system and the health departments doing the actual counting are not reporting the same thing.

The federal position

Federal officials have argued that 12 continuous months of cases should not automatically trigger loss of status. In January, they said an epidemic linkage through a common source between cases must be demonstrated. The U.S. reached the 12-month mark that month, a year after outbreaks were first reported on Jan. 20, 2025.

The U.S. has done viral genome sequencing and built a bioinformatics platform for molecular data analysis. The commission is evaluating both this week. Whether those data show one chain or several separate introductions is the central question.

HHS Secretary Robert F. Kennedy Jr. has said he is not "anti-vax" and that the government "promotes" the MMR vaccine. He has acknowledged it is highly effective and said children should get it. He has also questioned vaccine safety for decades. Asked about the figures, HHS pointed to a CDC statement that it is "working closely with state and local health departments to strengthen response efforts."

MMR use among children has fallen since the pandemic. A Johns Hopkins county-level data set published in June 2025 found that 78 percent of 2,066 counties studied reported a drop in vaccinations.

Mexico and the region

Mexico faces the same commission. Figures published by Tech Times put Mexico at 13,016 confirmed cases in 2026 and nearly 20,000 since its outbreak began in January 2025. They also show 49 deaths, most of them in Chihuahua, and transmission across all 32 states.

Across the Americas, PAHO counted 57,666 confirmed cases in 17 countries and territories from January through October 2026.

PAHO's rules mean Canada's loss in 2025 already cost the entire Americas region its status as free of endemic measles. Separately, international health panels recently revoked elimination status for six European and Central Asian countries: the United Kingdom, Spain, Austria, Armenia, Azerbaijan and Uzbekistan.

What comes next

The commission's meetings are closed and the national reports it reviews are confidential. The public will not see the evidence behind its recommendation, only the result.

That result is expected within days of Friday's adjournment. The open question is whether the sequencing data the U.S. submitted persuades the panel that the outbreaks were separate chains rather than one lineage running past the 12-month line.