U.S. Loses Measles Elimination Status After 26 Years

The United States is no longer a country that has eliminated measles. The Pan American Health Organization has revoked the country's measles-elimination status, ending a 26-year run, after determining the virus failed to stop circulating for more than a year, the Wall Street Journal reported on Friday, November 13, 2026. Reuters relayed the report, noting that PAHO did not immediately respond to a request for comment.

The decision turns on a single test. Elimination doesn't mean zero cases. It means the same strain of measles hasn't spread locally, uninterrupted, for 12 months or longer. PAHO reviewed epidemiological and laboratory evidence the CDC submitted, and the review concluded that a single lineage kept circulating for more than a year, a sign of local transmission rather than a run of imported cases.

The evidence was genetic. A strain called D8-9171 drove the large outbreaks in Texas, Utah and South Carolina, and a ProPublica review of 1,800 genomes found only 12 differences out of nearly 16,000 letters between the original Texas virus and a Utah virus sampled more than a year later. PAHO's Daniel Salas has said the United States is the only country using whole-genome sequencing to answer the elimination question.

The case count behind the decision is the worst in more than three decades. As of Thursday, November 12, the CDC had counted 5,182 confirmed measles cases in 2026 from 45 states, New York City and the District of Columbia, surpassing the 2025 total of 2,289. The CDC's November 13 update put the 2026 count at 5,412. Reuters reported that some 7,500 people in the U.S. have been infected with measles and 13 have died since 2025.

The review itself ran in the open. A panel of eight independent experts met in Washington for PAHO's Measles and Rubella Elimination Regional Monitoring and Re-Verification Commission, with the session running November 10 through November 13. The panel reached its finding by Friday night, but PAHO had not yet published it in its own name. The formal announcement is expected on Tuesday, November 17, according to NBC News and CIDRAP, and PAHO Director Jarbas Barbosa makes the final call on each country's status.

The U.S. isn't alone in losing the designation. Canada, Spain and the UK recently lost measles-elimination status after review by WHO experts. The U.S. dropped out of the WHO but remains a member of PAHO, its Americas branch, and the review was moved to November at U.S. officials' request from an original April 13 date.

The warning signs were on the record before the vote. KFF reported that the commission had placed the U.S. in a “sustained with major concerns” category ahead of the November review, and the review was originally set for an April 13 meeting before PAHO moved it to November at U.S. officials' request. The post-midterm timing drew political questions that the WHO rejected.

Losing the status carries no formal sanctions, a PAHO spokesperson told Scientific American, and the status is recoverable. To get it back, a country must end transmission and remain free of an outbreak for at least 12 months, submit a remedial plan to PAHO, and strengthen immunization, surveillance and response. The U.S. achieved elimination in 2000, when PAHO determined the country had interrupted endemic transmission. The road back runs through the same test it just failed.