As measles cases rise sharply to high levels in the US this year, there is wastewater, a new tool for tracking spread.
Wastewater monitoring became prominent during the COVID-19 pandemic as it helps test sewage in viral particles.
Now, Wastewaterscan has developed the first national wastewater monitoring program to detect measles where people are infected with the virus. It is possible that individuals will identify possible cases before they show symptoms or seek care. The new tool can be used at almost 150 wastewater treatment facilities in 40 states.
At least 1,157 measles cases have been reported in the United States this year, according to a CNN tally using data from the state’s health department.
It accounts for a large majority concentrated in West Texas. Texas reported 742 outbreak-related cases, New Mexico reported 81 cases, and Oklahoma reported 18 cases as of Tuesday. The Kansas lawsuit, which the state health department says could be linked to the outbreak, reached 71 as of Monday.
Experts say all of these numbers are strict undercounts. Because many cases have not been reported. However, with the disease declared in 2000, the country has reported less than 120 cases in all 2019 and reported in all 2019.
South Dakota reported the first measles incident on Monday, bringing the total number of states reporting at least one case in 2025 to a maximum of 33.
According to a news release from the state health department, the new incident in South Dakota is an adult travelling internationally.
The U.S. Centers for Disease Control and Prevention recently updated its measles guidance for travelers.
“Travelers can catch measles in many travel environments, including travel hubs such as airports and train stations, public transport such as planes and trains, tourist attractions, and large crowded events,” says CDC Advisory. “Infected travelers can return the disease to their hometown communities where they can rapidly spread among people who are not immune. The CDC recommends that all travelers be fully vaccinated against measles before traveling to international destinations.”
Other recent examples include Minnesota cases reported in adults exposed during air travel across the country, with the New Jersey Department of Health warning about potential exposure to measles at Newark Airport.
According to the CDC, there have been at least 14 outbreaks in the US this year, accounting for 90% of cases. CDC data is limited to the confirmed cases and delays behind this year’s CNN tally.
The majority of cases in the US this year came from people who have not been vaccinated. According to the CDC, only about 5% of confirmed cases are in those who receive one or two doses of the measles-mumpsulvera (MMR) vaccine.
Two doses of the MMR vaccine are 97% effective against measles. CDC recommends two doses as the best protection against illness, with the first dose being 12-15 months and the second dose being given between the ages of 4 and 6.
Childhood vaccination rates have been declining across the US over the years, with MMR vaccinations in kindergartens below the recommended 95% threshold for at least four years.
A new Johns Hopkins University study published in JAMA on Monday highlights how widespread the decline is. Research shows that MMR vaccination rates for children fell in more than three-quarters of US counties, down an average of 2.7% between 2017 and 2024.
However, vaccination rates have skyrocketed in some places that have experienced measles outbreaks. New Mexico has received almost twice the MMR vaccine this year than at this point, according to data from the state health department. Also, a recent analysis of health records by healthcare data and analytics firm Truveta shows that early vaccination rates jumped among toddlers in Texas. Texas’ six-month-old MMR vaccination rates this year were more than eight times higher than in 2019, with about one in five people who were filmed for Texas’ first measles in March and April getting early before their first birthday.
At least 133 people with measles have been hospitalized this year, with three deaths, according to the CDC. Two children in Texas and one adult in New Mexico, all of whom weren’t vaccinated.