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Measles, Once Vanquished, Now Returned
by George Shiflet and Angela Shiflet
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In early December 2025, there were a total of 1,912 confirmed cases of measles in the United States (US) (Figure 1). In the relatively small state of South Carolina, there were 114 reported cases of measles, with 27 new cases December 5-10. According to the state’s Department of Public Health, 16 of these cases originated from exposure in a church in Inman (Spartanburg County), while other cases originated in four public schools in the same county. As of December 10, there remained quarantined 254 people and 16 in isolation. Characteristically, most cases occurred in people that were unvaccinated (DPH 2025).
Figure 1. A baby with measles.
Source: Jim Goodson, Centers for Disease Control and Prevention, https://commons.wikimedia.org/wiki/File:Measles_child_Philippines.jpg
Caused by an RNA virus, measles is one of the most contagious of all communicable diseases. During the during the early part of the 20th Century, four-thousand people died of measles; and before 1963, most children had suffered from measles before age 15.
In 2000, the CDC announced that measles had been eliminated in the United States, meaning there had been no sustained local transmission of this dangerous illness. In 2025, the ‘elimination’ status came into jeopardy. This loss of status could lead to travel restrictions into and out of the United States, with negative impact on tourism and business travel. The best preventative is widespread vaccination with the very effective measles vaccine. Most people in the US born before 1957, are assumed to have had the disease, which generally results in lifetime immunity to the virus. The vaccine is usually given to children at one-year-old and age 4-6. The vaccine normally is highly effective at preventing the disease and is, thus, required for entry into the public school system in most locations. Most states permit exemptions for medical, religious, or philosophical reasons. However, maintaining high levels of vaccination in the population is extraordinarily important to development of herd immunity, which sharply reduces the chances of getting the disease.
Measles is an extremely disagreeable disease that can lead to hospitalization or even death. Spread easily, the measles virus is normally transmitted through coughing or sneezing and can remain in the air for up to two hours. It is also possible to become infected from viruses obtained from contaminated surfaces and subsequently transported to the mouth, nose, or eyes. Those exposed to the virus may be contagious several days prior to showing any symptoms.
Unfortunately, many parents have been reluctant to have their children vaccinated. Although, the vaccine has been around for years, proven safe and effective, doubts have been planted by those with questionable motives and little evidence. Social media/internet sources have been at the forefront of spreading false information about vaccines. During election times, the Russians have used bots to interfere with and influence elections, to spread medical misinformation, which sews doubt in science and medicine. Alas, various groups have reduced trust in a remarkable tool for preventing a number of infectious diseases, or at least reducing the symptoms. Vaccines have been one of the most effective weapons developed for public health.
In 2025, Kiang et al., published results of their model of declining vaccination for measles and three other infectious diseases in the United States. Widespread, routine use of the measles-mumps-rubella (MMR) vaccine for children eliminated all three of these diseases in the US. The authors developed an individual-based model (i.e., agent-based model) involving vaccination, modeling each state and each disease independently and using data for the states and diseases.
Running the simulation numerous times and using the current state-level vaccination rates, the model of Kiang et al. (2025) predicted 851,300 mean number of measles cases over a 25-year period. Encouragingly, if vaccination rates were 5% higher, their work predicted only 5,800 total cases. However, a 10% decline in MMR vaccination from the current level was estimated to result in a dramatic increase in the number of cases over a 25-year period with about 11.1 million people becoming sick with measles. Moreover, under the current vaccination numbers, 83% of the simulations resulted in measles becoming endemic, or regularly occurring, after mean of 20.9 years.
Kiang MV, Bubar KM, Maldonado Y, Hotez PJ, Lo NC. Modeling reemergence of vaccine-eliminated infectious diseases under declining vaccination in the US. JAMA. Published online April 24, 2025. doi:10.1001/jama.2025.6495. Accessed 04/28/25 https://jamanetwork.com/journals/jama/article-abstract/2833361.