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The year is 2026, six years after the world endured the COVID-19 pandemic. Yet another infectious disease is raising its head, even in some of the world's most developed countries.
Measles was declared eliminated in the United States in 2000. This meant that continuous transmission of the virus had been interrupted for at least 12 months. However, 2025 marked a troubling resurgence, with cases reaching levels not seen in decades.
A Troubling Comeback
Measles is making a troubling comeback across the world, with major outbreaks reported in South Asia, the Americas, Africa and other regions. The latest figures highlight the scale of the challenge.
The United States reported 4,080 confirmed cases as of 8 October 2026, according to the US Centers for Disease Control and Prevention (CDC). New York has declared a disaster emergency in response to a growing outbreak, while neighbouring Pennsylvania has reported more than 1,000 cases.
These developments underline a sobering reality, even countries with advanced healthcare systems are vulnerable when vaccination gaps allow the virus to spread.
The South Asian Crisis
Bangladesh is battling an exceptionally severe outbreak. More than 166,000 suspected cases and 999 suspected or confirmed measles-related deaths have reportedly been recorded since March 2026, including 100 confirmed measles deaths.
The outbreak has exposed the consequences of missed childhood vaccinations and disruptions to routine immunisation. When children remain unprotected, the virus can spread rapidly, placing enormous pressure on healthcare services and putting vulnerable populations at risk.
According to the CDC's global surveillance summary, major outbreaks during February-July 2026 were reported in Bangladesh, Guatemala, India, Yemen, Pakistan, Mexico, Cameroon, South Africa, Kazakhstan and Angola. These figures demonstrate the international scale of the resurgence, although reporting periods and case definitions vary between countries.
"INDIA SHOULD CONSIDER BANGLADESH THE WARNING AND NEW YORK THE REMINDER"
"The measles outbreaks in Bangladesh and New York offer an important warning to India: no country can afford complacency. Measles is among the most contagious human infections. Its basic reproduction number, known as R-naught, is exceptionally high, meaning that one infected person can transmit the virus to many susceptible individuals. Approximately 95% coverage with two doses of a measles-containing vaccine is generally needed to interrupt sustained community transmission," says Dr Ishwar Gilada, Infectious Diseases Specialist.
Dr Gilada adds that India has an advantage vis a vis its immunisation programme.
"India has a very strong childhood Universal Immunization Programme (UIP), renamed by the National Health Mission in 1985, from the Expanded Programme on Immunization (EPI) launched in 1978 by the Ministry of Health and Family Welfare. As for Measles, nearly with 98% of children have received first dose and 95% of them have completed second dose as well," he says.
What about Herd immunity?
National averages of immunisation can conceal pockets of low coverage, the reasons don't matter.
"Herd immunity for Measles is only as strong as the protection achieved in every community and 95% of vaccination is considered excellent for the herd immunity. We must identify children who have missed either vaccine dose, strengthen surveillance, address vaccine hesitancy in any pocket or community, rapidly investigate suspected cases and respond promptly to outbreaks whenever they occur. Unvaccinated, malnourished and immune-compromised children are more vulnerable to catch Measles easily," says Dr Gilada.
READ | Bangladesh Measles Outbreak Claims 9 More Lives; Total Deaths Near 1,100
So should you be worried?
India should be alert, not alarmed say experts. Measles is preventable, and no child should suffer or die from a disease for which an effective vaccine is available.
"The only way to stop the spread of measles is to it is to place roadblocks in its path - the presence of a vaccinated person is such a roadblock, and many such persons ensures the virus can't get through at all. That's called herd immunity- and considering the high spreading potential of measles, a suitably high level of herd immunity is recommended- in excess of 95%. Unfortunately in recent times that percentage dropped in many communities in India and elsewhere, essentially giving the virus a free run in these hotspots," says Dr Rajeev Jaydevan, Former President of the Indian Medial Association and Senior Gastroenterologist.
So why do infections return?
"A special concern about measles is its ability to make our immune system "forget" whatever we were trained to defend against in the past. This means the child who recovered will remain susceptible to certain infections which it had previously gained immunity against. This leaves a trail of death and disease in the years that follow - which aren't always tracked back to the earlier measles bout. The solution is to persist with catch-up vaccination and also remove vaccine hesitancy and misinformation existing in specific pockets of the population," says Jaydevan.
Why India becomes important?
India's role is laudable in the Global Health and in achieving 'One World One Health' motto as the global pharmacy and the global vaccine supplier. Approximately 80% of measles-rubella (MR) vaccine doses used worldwide came from Serum Institute of India in 2022 according to the WHO and UNICEF.
India has a strong childhood Universal Immunisation Programme (UIP), building on the Expanded Programme on Immunisation launched in 1978 by the Ministry of Health and Family Welfare. Although India's measles vaccination coverage is high, national averages can conceal pockets of under-immunisation.
Reported coverage figures of approximately 98% for the first dose and 95% for the second dose are encouraging. However, high national coverage does not necessarily mean that every community is adequately protected. Herd protection depends on achieving high immunity across all population groups, including underserved and hard-to-reach communities.
India must identify children who have missed either dose, strengthen disease surveillance, address vaccine hesitancy through evidence-based communication, rapidly investigate suspected cases and respond promptly to outbreaks.
Unvaccinated, malnourished and immunocompromised children are particularly vulnerable to severe measles complications.
What is measles?
Measles is a highly contagious viral disease that spreads through the air when an infected person breathes, coughs or sneezes. The virus can remain infectious in the air and on contaminated surfaces for a period after an infected person has left the area.
Early symptoms typically include high fever, cough, a runny nose and red, watery eyes. Small white spots may appear inside the mouth. A characteristic red rash usually develops several days later, beginning on the face and spreading across the body.
Although some people recover without major complications, measles can cause pneumonia, severe diarrhoea, dehydration, blindness and encephalitis, or inflammation of the brain. In rare cases, a serious and progressive neurological complication known as subacute sclerosing panencephalitis (SSPE) can develop years after the initial infection.
Young children, malnourished individuals and people with weakened immune systems face a greater risk of severe illness and death.
Vaccine coverage ignored?
The resurgence is largely driven by gaps in vaccination coverage. Two doses of a measles-containing vaccine provide approximately 97% protection against measles. However, when children miss their scheduled doses, susceptible individuals accumulate within communities, allowing the virus to spread rapidly.
Several factors contribute to the problem:
- Disrupted immunisation programmes: The COVID-19 pandemic, conflict and healthcare-system challenges interrupted routine vaccination in many settings, leaving children without timely protection.
- Vaccine hesitancy and misinformation: Misleading information about vaccine safety can discourage families from immunising their children.
- Poverty and unequal healthcare access: Children in remote, displaced and underserved communities may not receive timely vaccinations because of geographical, financial or social barriers.
- International travel: Infected travellers can introduce measles into communities where immunity is insufficient, triggering outbreaks.
- Weak disease surveillance: Delays in diagnosis, reporting, laboratory confirmation and outbreak response can allow transmission to continue undetected.
Measles is preventable, but prevention depends on sustained vaccination coverage, timely identification of cases and a coordinated public health response. Even a relatively small immunity gap can have serious consequences because of the virus's exceptional contagiousness.
Decades of progress threathened
The return of measles threatens decades of progress in controlling vaccine-preventable diseases. Outbreaks can overwhelm hospitals, increase healthcare costs, disrupt schooling and place additional pressure on families and public health services.
The consequences may extend beyond the immediate infection. Measles can cause immune amnesia, damaging aspects of the immune system's memory of previous infections and potentially increasing vulnerability to other illnesses. This can leave recovering individuals susceptible to infections against which they had previously developed immunity.
The problem is not confined to lower-income countries. The resurgence in the United States demonstrates that outbreaks can occur even in countries with advanced medical infrastructure when vaccination gaps persist.
The lesson is clear: progress in disease control is not irreversible. Sustained investment in immunisation, surveillance and public awareness is essential to protect the gains achieved over previous decades.
How can the resurgence be stopped?
- Public health experts emphasise that the most effective response is to close immunity gaps and ensure that every eligible child receives the recommended vaccine doses.
- Improvement in strengthen surveillance and laboratory testing gets important.
- Rapid identification of suspected cases, laboratory confirmation, contact tracing and timely reporting can help prevent isolated cases from developing into larger outbreaks.
- India must remain alert, no alarmed
The global resurgence of measles is a warning that no country can afford complacency. Bangladesh shows the dangers of substantial immunity gaps, while New York demonstrates that even highly developed healthcare systems are not immune to outbreaks.
Measles is among the most contagious diseases we know, so a rise in cases in one country is never only that country's problem experts say.
"With global travel at current levels, an unvaccinated person can pick up the infection abroad and carry it home within days. India is not outside this picture. Measles still circulates here, and pockets of under-vaccinated children, often in densely populated or hard-to-reach areas, allow for the outbreaks to happen. Immunisation is very important for prevention against measles. Parents should check their children's immunisation records, and adults planning international travel should confirm their own protection beforehand. India's size, its dense urban populations, and the constant movement of people between cities, villages, and abroad mean that a single imported case can reach many unprotected children quickly. Where routine immunisation has slipped, whether through missed doses, disrupted health services, or hard-to-reach communities, the risk is that small clusters can turn into sustained outbreaks" adds Dr. Vikram Jeet Singh, Senior Director, Internal Medicine, Aakash Healthcare
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