PAHO Panel Meets This Week on U.S. Measles Elimination Status as CDC Count Reaches 5,182

Since the first outbreak cases surfaced in West Texas on Jan. 20, 2025, U.S. measles has gone from a regional flare-up to a 5,182-case national year. This week it faces a formal verdict. PAHO's Regional Verification Commission is meeting in a closed-door, three-day session to evaluate the United States and Mexico.

The meeting was originally set for April 2026. It was pushed to November so authorities could finish technical analyses. The CDC had also asked for more time to determine whether cases were spreading domestically or were imported.

What the commission is deciding

The test is genetic, not a head count. PAHO defines re-established endemic transmission as the same virus genotype and lineage circulating without interruption for 12 months or more in a specific area. For the U.S., PAHO set the clock at the outbreak onset of Jan. 20, 2025. Mexico's start date is Feb. 1, 2025.

The commission is an independent technical body that reports to PAHO's director. It hands its recommendations to the director, who then formally notifies national governments of the classification. A public announcement may therefore come after the meeting ends.

U.S. officials have contested the premise. In January, federal officials argued that 12 months of continuous cases should not automatically trigger a loss of status without showing an epidemic linkage through a common source between cases. The U.S. has also built a viral genome sequencing and bioinformatics platform, which the commission is set to evaluate.

There is precedent. PAHO concluded in November 2025 that endemic transmission was re-established in Canada, which had confirmed 5,197 cases that year. That ruling cost the entire Americas region its status as free of endemic measles. Six European and Central Asian countries, including the United Kingdom and Spain, have also lost theirs.

The national numbers

The CDC's latest update, dated Nov. 6 with data through Nov. 5, counts 5,182 confirmed cases in 2026. For all of 2025 it counted 2,289 cases. The agency lists 43 new outbreaks this year. About 96% of cases, or 4,993, are linked to outbreaks.

The week added 330 cases, the 13th straight week of a triple-digit increase. Some 96% of patients were unvaccinated or of unknown vaccination status. About 11% have been hospitalized, which is 562 people. Only Arkansas, Hawaii, Mississippi, Nevada and New Hampshire have reported no cases.

Kindergarten MMR coverage was 92.4% in the 2025-2026 school year, down from 95.2% in 2019-2020. That is below the roughly 95% level scientists say is needed to block spread. Two doses of the vaccine are 97% effective.

Deaths and the hot spots

The CDC lists four measles deaths this year and marks the figure as subject to change. State health departments are reporting more. Pennsylvania has confirmed six deaths and is investigating a seventh in Franklin County.

A child in New York and an infant in Wisconsin were reported dead in the past week, according to those states' health departments. CIDRAP noted neither state had reported such a death since the 1990s.

Wisconsin's count has reached 477 cases, a 35-year high for the state, according to its health department. New York stands at 210.

Pennsylvania remains the national leader. It crossed 1,500 cases on Monday, Nov. 9, with 73 new cases in the past seven days, including one rare breakthrough infection in a vaccinated person. The outbreak has touched more than half of the state's 67 counties.

Dr. Paul Offit of Children's Hospital of Philadelphia said the state may be gaining ground. "I don't want to jinx it, but it looks like we may be getting on top of it here in Pennsylvania," he said, crediting the state health department for getting MMR vaccine into under-immunized communities.

What a loss would and would not mean

Offit is not optimistic about the national picture. He said he believes measles is now endemic in the U.S. "I think we're going to see measles again next year, and the year after that, and the year after that, until we get on top of vaccinating our populace," he said.

He told ABC News that losing the designation "at best" would be "a call to arms." He added that "we should be proud as a nation that we were able to eliminate the world's most contagious infectious disease."

The designation itself carries no direct penalty. Sources told CIDRAP the meeting's outcome is largely symbolic, and the Philadelphia Inquirer likewise called it largely symbolic. The outbreak numbers do not change with the label.

Some of the blame is contested. Scary Mommy reported that experts fault the Trump administration and HHS Secretary Robert F. Kennedy Jr. for falling vaccination rates. Kindergarten exemptions hit a record 4.2% in 2025-2026, and 39 states fell below the 95% threshold. The CDC went a full year without a Senate-confirmed director during this outbreak. Neither Kennedy nor HHS is quoted responding in the material reviewed for this story.

Timing is unclear. PAHO has not said when its director will communicate the U.S. determination, and the commission's recommendation is not public until he does.