WSJ Reports PAHO Revoked U.S. Measles Elimination Status; Two More State-Reported Deaths Bring Toll to 10

Since the Pan American Health Organization convened a closed-door review this week, the question of whether the U.S. keeps its measles elimination status has moved from "undecided" to "reportedly gone."

The Wall Street Journal reported Friday, Nov. 13, citing people familiar with the matter, that PAHO has revoked the status after concluding the country failed to stop continuous transmission for more than a year. That would end a 26-year run. PAHO did not immediately respond to a request for comment on the report.

What the decision turns on

The test is genetic. PAHO reviewed epidemiological and laboratory evidence submitted by the CDC to determine whether the same measles strain had circulated in the U.S. for 12 months or longer. That pattern points to local transmission rather than imported cases.

Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security, put it this way: "It's solely based on genetics."

Noel Brewer, a University of North Carolina public health professor who chairs an independent advisory panel on measles, presented the CDC's status report and his group's assessment to PAHO on Tuesday. That report remains confidential, but a source familiar with the CDC's findings said the agency determined the U.S. had 12 months of continuous transmission of the virus. Brewer said: "It is a fully preventable disease. It is unconscionable that we have this amount of measles."

According to PAHO officials, the commission presents its determination to PAHO Director Dr. Jarbas Barbosa, who makes the final call. They had said an announcement of the findings was being scheduled for next week. PAHO stripped Canada of its status last year. The U.S. dropped out of the World Health Organization but remains a member of PAHO, its Americas branch.

Two more deaths, and two different counts

Pennsylvania and Wisconsin each reported a measles-associated death Friday.

Wisconsin's health department reported the death of a child. The state has logged 649 cases since August, and reported its first measles death since 1990 just last week. Pennsylvania's health department said its latest death was an unvaccinated resident.

That puts Pennsylvania at seven deaths among 1,542 cases, the most of any state. Wisconsin has two, and New York has one among 210 cases. State health departments now count 10 deaths this year.

The CDC still lists six. The gap comes from definitions. The CDC counts a death only when the National Center for Health Statistics lists measles as the underlying cause on the death certificate. Pennsylvania counts a death as measles-associated if it occurs within 30 days of symptom onset in a person with clinical evidence of measles and a positive lab test, and is not due to unrelated causes.

The CDC logged three measles deaths last year, so its 2026 figure is already double that.

The case count

The CDC reported 5,412 confirmed cases as of Nov. 12, up 230 from its previous update and the highest total in decades. Hospitalizations stand at 591. Last year's full total was 2,289.

The CDC says 97% of cases are in unvaccinated people. Kindergarten MMR coverage for 2025-26 was 92.4%, according to the CDC. Before the pandemic it was 95%, the level needed for herd immunity.

The federal response

CDC Director Dr. Erica Schwartz has said losing the designation changes nothing about the agency's approach. "The measles elimination designation is not what protects Americans. Vaccination does," she said in a statement. "We know where transmission is occurring and we're working with state and local health departments to reach those communities."

Many public health experts disagree that business-as-usual is enough. They call for a stepped-up vaccination campaign and more guidance to doctors, fault what they describe as a muted, politically fraught federal response, and blame Health Secretary Robert F. Kennedy Jr., a leading anti-vaccine activist before he took the job. Dr. David Margolius, Cleveland's health director and a leader in a coalition of big-city health departments, called the loss of status "moving backward."

The administration's recent moves have drawn the same criticism. The CDC cited safety concerns in recommending separate MMR and varicella vaccines. The Trump administration has also proposed splitting the MMR vaccine into three individual shots. MedPage Today reported that such a change would almost certainly push already-slipping vaccination rates lower. That is that outlet's assessment, not a finding.

What comes next

The formal PAHO announcement is the next marker. Mexico's status was under review in the same process, and no outcome for it has been reported. CDC data updates will show whether the case count keeps climbing; the latest update added 230 cases.

Whether the CDC ever reconciles its six deaths with the states' 10 is also open. The CDC has said it is working with the Council of State and Territorial Epidemiologists to establish a standardized definition for measles deaths.