Health experts meeting this week are expected to confirm that measles has officially returned to the United States and Mexico, ending one of each country's greatest public health victories.
asserted
measles → meet → victories
The Pan American Health Organization (PAHO) convened the meeting to examine whether the virus is now spreading continually within the nations' borders.
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virus → convene → borders
Measles is among the most contagious diseases known to medicine, yet vaccines have safely stopped the virus's spread in the U.S. for 30 years.
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vaccines → know → years
Over those decades, the disease became a medical rarity in the U.S., with deaths from it virtually unheard of.
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deaths → become → it
The past two years have changed that picture, as large outbreaks have hit multiple states and spawned thousands of illnesses, including about a dozen deaths.
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outbreaks → change → deaths
“It’s a big deal.
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It → ’ → ?
The decision represents us moving backward,” said Dr. David Margolius, director of Cleveland's health department and a leader in a coalition of big U.S. city health departments.
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Margolius → represent → departments
The deliberations are taking place behind closed doors, where a PAHO advisory commission is poring over genetic evidence to determine whether the same measles virus has been spreading for at least one year in the outbreaks that have torn through North America since 2024.
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that → take → 2024
“It’s solely based on genetics,” said Dr. Amesh Adalja, an infectious disease doctor in the Pittsburgh area and a senior scholar at the Johns Hopkins Center for Health Security.
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Adalja → base → Security
If the commission finds that it has, it will say the country can no longer be considered to have “eliminated” measles, meaning the virus has returned to sustained circulation.
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virus → find → circulation
Canada has already lost its own designation, which PAHO stripped last year after the country had held it since 1998.
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country → lose → 1998
The commission will present its determination to PAHO Director Dr. Jarbas Barbosa, a former Brazilian health official, who makes the final determination.
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who → present → determination
PAHO officials said they are scheduling an announcement of the findings for next week.
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they → say → week
Whatever the outcome, the CDC says its approach will not change.
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approach → say → ?
A PAHO decision to strip the U.S. of its measles elimination status will not change how federal health officials are addressing outbreaks, CDC Director Erica Schwartz said this week.
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Schwartz → strip → outbreaks
“The measles elimination designation is not what protects Americans.
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what → protect → Americans
Vaccination does.
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Vaccination → do → ?
We know where transmission is occurring, and we’re working with state and local health departments to reach those communities.
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we → know → communities
Losing a designation doesn’t mean we abandon an evidence-based approach.
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we → lose → approach
It means we remain focused on stopping outbreaks,” she said in the statement.
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she → mean → statement
Many public health experts disagree, arguing that such an occasion demands a stepped-up, full-throated campaign to promote vaccinations and give doctors more guidance.
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occasion → disagree → guidance
They fault what they say is a politically fraught, muted federal response, and blame U.S. Health Secretary Robert F. Kennedy Jr., who was a leading voice in the anti-vaccine movement before President Donald Trump put him in charge of the nation's health agencies.
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Trump → fault → agencies
Kennedy has moved to downsize the childhood vaccination schedule and reshape a key vaccine advisory board.
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Kennedy → move → board
He has also lauded Trump's executive order calling for spacing out the measles, mumps and rubella vaccine, a move that runs counter to medical groups' recommendations and likely would result in fewer children getting fully vaccinated, experts say.
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experts → laud → recommendations
The stakes are high, because the U.S. is having its worst measles year in decades.
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U.S. → have → decades
The country has now seen eight measles-associated deaths this year, more than any year in more than three decades, and is enduring its worst year for measles illnesses since 1991.
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country → see → 1991
This year's more than 5,100 confirmed cases are already double the 2025 tally, driven largely by an outbreak in Pennsylvania that has dwarfed earlier ones.
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that → confirm → ones
Measles exploded last year in large outbreaks in Texas, Arizona, Utah and South Carolina.
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Measles → explode → Texas
The disease typically begins with a high fever followed by a telltale rash that starts on the face and neck.
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that → begin → face
Most people recover, but measles is one of the leading causes of death among young children, according to the World Health Organization.
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measles → recover → Organization
Serious complications, including blindness and swelling of the brain, are more common in young children and adults older than 30.
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complications → include → 30
The U.S. achieved measles elimination status in 2000, after decades of vaccination campaigns brought childhood measles vaccination rates above 97%.
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decades → achieve → %
Health experts say a 95% vaccination rate is needed so that when an infected traveler enters a community, enough people are vaccinated to prevent an outbreak.
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people → say → outbreak
But U.S. vaccination rates have been slipping for years, in part because of disproven claims that the vaccine can cause autism.
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vaccine → slip → autism
Trump claimed earlier this year, without evidence, that the MMR vaccine, which is credited with saving millions of lives globally, is possibly “quite lethal.”
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which → claim → lives
Last year, the childhood vaccination rate fell to about 92% nationally, and was much lower in certain states and certain communities.
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rate → fall → states
Mexico's story runs on a different timeline.
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story → run → timeline
A measles vaccine did not become available there until years after a measles vaccine was first licensed, in 1963, in the U.S., and the U.S. started giving shots.
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U.S. → become → shots
Mexico did not achieve measles elimination status until 2016.
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Mexico → achieve → 2016
Cases began surging in south of the border early last year.
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Cases → surge → border
…and 5 more, not listed.
The Aporia
