US measles cases surpass 700 with outbreaks in six states. Here's what to know

Texas health officials confirmed 20 more cases of measles in its nearly 3-month-old outbreak Tuesday, alongside five new cases in New Mexico and six in central Ohio.

Last week, U.S. measles cases topped 700 as Indiana joined five others states with active outbreaks. Even as the virus continued to spread and the U.S. Centers for Disease Control and Prevention redeployed a team to West Texas, Health Secretary Robert F. Kennedy Jr. claimed in a televised Cabinet meeting Thursday that measles cases were plateauing nationally. The U.S. has more than double the number of measles cases it saw in all of 2024.

Texas is reporting the majority of measles cases. Two unvaccinated elementary school-aged children died from measles-related illnesses near the epicenter of the outbreak in rural West Texas. An adult in New Mexico who was not vaccinated also died of a measles-related illness.

Other states with active outbreaks — defined as three or more cases — include Indiana, Kansas, Oklahoma and Ohio.

The multistate outbreak confirms health experts' fears that the virus will take hold in other U.S. communities with low vaccination rates and that the spread could stretch on for a year. The World Health Organization has said cases in Mexico are linked to the Texas outbreak.

Measles is caused by a highly contagious virus that's airborne and spreads easily when an infected person breathes, sneezes or coughs. It is preventable through vaccines, and has been considered eliminated from the U.S. since 2000.

Here's what else you need to know about measles in the U.S.

Texas' outbreak began in late January. State health officials said Tuesday there were 20 new cases of measles since Friday, bringing the total to 561 across 23 counties — most of them in West Texas. Two more Texans were hospitalized, for a total of 58 throughout the outbreak, and Reeves County logged its first case.

State health officials estimated Tuesday that about 4% of cases — fewer than 25 — are actively infectious.

Sixty-five percent of Texas' cases are in Gaines County, population 22,892, where the virus started spreading in a close-knit, undervaccinated Mennonite community. The county has logged 364 cases since late January — just over 1% of the county's residents.

The April 3 death in Texas was an 8-year-old child, according to Kennedy. Health officials in Texas said the child did not have underlying health conditions and died of ''what the child's doctor described as measles pulmonary failure.'' A unvaccinated child with no underlying conditions died of measles in Texas in late February — Kennedy said age 6.

New Mexico announced five new cases Tuesday, bringing the state's total to 63. Three more people are in the hospital, for a total of five since the outbreak started. Doña Ana County reported its first case. Most of the state's cases are in Lea County. Two are in Eddy County and one in Chaves County.

How many cases are there in Kansas?

Kansas has 32 cases in eight counties in the southwest part of the state, health officials announced Wednesday. Two of the counties, Finney and Ford, are new on the list and are major population centers in that part of the state. Haskell County has the most with eight cases, Stevens County has seven, Kiowa County has six, and the rest have five or fewer.

The state's first reported case, identified in Stevens County on March 13, is linked to the Texas and New Mexico outbreaks based on genetic testing, a state health department spokesperson said. But health officials have not determined how the person was exposed.

How many cases are there in Oklahoma?

Cases in Oklahoma remained steady at 12 total cases Tuesday: nine confirmed and three probable. The first two probable cases were ''associated'' with the West Texas and New Mexico outbreaks, the state health department said.

How many cases are there in Ohio?

The Knox County outbreak in east-central Ohio has infected a total 20 people as of Tuesday, according to a news release from the county health department, but seven of them do not live in Ohio. In 2022, a measles outbreak in central Ohio sickened 85.

The Ohio Department of Health confirmed 20 measles cases in the state last week: 11 in Ashtabula County near Cleveland, seven in Knox County and one each in Allen and Holmes counties. The state updates its count on Thursdays, and it only includes Ohio residents.

The outbreak in Ashtabula County started with an unvaccinated adult who had interacted with someone who had traveled internationally.

How many cases are there in Indiana?

The cases have no known link to other outbreaks, the Allen County Department of Health said Wednesday. The first case was confirmed Monday.

Where else is measles showing up in the U.S.?

Measles cases also have been reported in Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Kentucky, Maryland, Michigan, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island, Tennessee, Vermont, and Washington.

The U.S. Centers for Disease Control and Prevention defines an outbreak as three or more related cases. The agency counted seven clusters that qualified as outbreaks in 2025 as of Friday.

In the U.S., cases and outbreaks are frequently traced to someone who caught the disease abroad. It can then spread, especially in communities with low vaccination rates. In 2019, the U.S. saw 1,274 cases and almost lost its status of having eliminated measles. So far in 2025, the CDC's count is 712.

The best way to avoid measles is to get the measles, mumps and rubella (MMR) vaccine. The first shot is recommended for children between 12 and 15 months old and the second between 4 and 6 years old.

People at high risk for infection who got the shots many years ago may want to consider getting a booster if they live in an area with an outbreak, said Scott Weaver with the Global Virus Network, an international coalition. Those may include family members living with someone who has measles or those especially vulnerable to respiratory diseases because of underlying medical conditions.

Adults with ''presumptive evidence of immunity'' generally don't need measles shots now, the CDC said. Criteria include written documentation of adequate vaccination earlier in life, lab confirmation of past infection or being born before 1957, when most people were likely to be infected naturally.

A doctor can order a lab test called an MMR titer to check your levels of measles antibodies, but experts don't always recommend it and health insurance plans may not cover it.

Getting another MMR shot is harmless if there are concerns about waning immunity, the CDC says.

What are the symptoms of measles?

Measles first infects the respiratory tract, then spreads throughout the body, causing a high fever, runny nose, cough, red, watery eyes and a rash.

The rash generally appears three to five days after the first symptoms, beginning as flat red spots on the face and then spreading downward to the neck, trunk, arms, legs and feet. When the rash appears, the fever may spike over 104 degrees Fahrenheit, according to the CDC.

Most kids will recover from measles, but infection can lead to dangerous complications such as pneumonia, blindness, brain swelling and death.

How can you treat measles?

Why do vaccination rates matter?

In communities with high vaccination rates — above 95% — diseases like measles have a harder time spreading through communities. This is called ''herd immunity.''

But childhood vaccination rates have declined nationwide since the pandemic and more parents are claiming religious or personal conscience waivers to exempt their kids from required shots.

The U.S. saw a rise in measles cases in 2024, including an outbreak in Chicago that sickened more than 60.

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