By most metrics, measles in the U.S. is out of control. Last week alone, cases jumped by 8%, with 330 infections reported, outpacing the entire total of cases in 2024, in which the Centers for Disease Control and Prevention counted 285 cases. There are large outbreaks in Texas and South Carolina, but Pennsylvania has been hit especially hard lately, with over 1,300 cases and 250 hospitalizations reported this year so far. Due to underreporting, public health officials caution that the true number of cases is likely higher, potentially as high as 6,000. 

“We’ve seen more measles cases during this report than we’ve seen in the last quarter century — combined,” Noel Brewer, a professor of public health at the University of North Carolina, told POLITICO this week. Brewer served on a key vaccine advisory panel to the CDC before Health and Human Services Secretary Robert F. Kennedy Jr., a noted believer and spreader of anti-vaccine conspiracies, overhauled the committee. 

A highly contagious viral disease, measles is characterized by a distinct rash. Though most people recover, it can cause pneumonia, blindness and swelling in the brain, and erase the immune system’s memory, leading to easily acquired secondary infections. About one to three people out of 1,000 die from measles, with children at the greatest risk of dying. Vaccines against measles are highly effective and safe. According to the World Health Organization, between 2000 and 2024, an estimated 59 million deaths globally were prevented by measles vaccination.

Data from the CDC reports there have been 42 outbreaks this year, there have been at least 4,410 confirmed measles cases as of Oct. 15, almost double the total in 2025. But critics say the CDC isn’t giving the full story. The agency’s measles dashboard lists three deaths, adding one on Wednesday, but Pennsylvania has alone reported five deaths this year, with a sixth under investigation. The CDC still hasn’t named the state where the latest death occurred, although health experts say there is no reason to withhold this info.

Why the discrepancy? That’s what Pennsylvania’s Health Secretary Debra Bogen wants to know. Late last week, Bogen sent a letter to CDC Director Erica Schwartz requesting that the state’s deaths be counted and demanding answers on how the agency is tracking measles fatalities. “By not acknowledging the deaths, the CDC obscures the seriousness of this disease and the toll of measles across the U.S.,” Bogen wrote. Schwartz has only been CDC director since August, replacing acting director Jay Bhattacharya.

It’s not the first time Bogen has sent such a letter. In September, she asked Schwartz to acknowledge the deaths back when the number was four. Later that month, Reuters reported that Kennedy asked Schwartz to remove two measles deaths from the CDC’s dashboard, which she implemented “without objection,” according to three sources familiar with the matter. While the deaths have since been added back to the tally, they are marked with an asterisk indicating that the “number is subject to change.” 

Start your day with essential news from Salon.
Sign up for our free morning newsletter, Crash Course.

Pennsylvania Gov Josh Shapiro, a Democrat, has also taken issue with the CDC’s response, publicly blaming Kennedy and the Trump administration for sowing doubt about vaccines. Kennedy has denied being at fault, dismissing the outbreak as a global problem and saying, “We have done better, and particularly, my administration has done better at controlling the outbreak than any other country in the world.” 

Kennedy has made this claim before. It’s true that other countries have seen skyrocketing measles cases, especially Indonesia, Guatemala, India and Bangladesh, with the latter registering over 65,000 infections in the last 12 months. That doesn’t change the fact that the U.S. is experiencing a severe failure to protect the public from measles, with vaccination rates continuing to fall. Yet Kennedy has been reluctant to promote vaccines, continues to cast doubt on their safety and upholds unproven remedies for treating measles, like vitamin A and cod liver oil. That advice has been associated with an increase in calls to poison control for vitamin A exposure, according to research published in June in JAMA Network.

Kennedy has tried to flip the script by accusing Shapiro of “politicizing” the outbreak and refusing federal help. But that assistance was only initially refused because the CDC was not counting deaths accurately, with Pennsylvania requesting emergency assistance in September. The state and the federal government are now working together. Last week the CDC sent a “disease detective” within the agency’s Epidemic Intelligence Service to Pennsylvania.

All this comes as the WHO is due to review the U.S. status on measles elimination, which was achieved in 2000 and is given when a country goes a full 12 months without continuous transmission of the virus. But when the Pan American Health Organization, an arm of the WHO, meets in November, they are expected to revoke the U.S.’s status, just as it did to Canada last November, 25 years after our northern neighbor had eliminated the disease.

Measles is just one of seemingly countless self-inflicted crises at the heart of the Make America Healthy Again movement, which Kennedy spearheaded in his 2024 presidential bid before endorsing Trump and joining the administration. As such, Kennedy has been busy lately stumping for Republicans in the midterms, sometimes hopping aboard military planes to do it, while MAHA-aligned groups have spent nearly $2 million backing candidates associated with the health secretary. POLITICO reported last week that “the MAHA PAC and MAHA Action PAC, two political action committees supporting candidates committed to the health secretary’s agenda, announced they donated a combined $1.65 million to support Republican Zach Lahn’s campaign for governor of Iowa.”

Other than elections, Kennedy’s major focus lately is redefining junk food, but the public is apparently increasingly losing trust in the MAHA movement. Recent data from an Axios-Ipsos poll suggests that only one in four people trust health information coming from Kennedy. While he has emerged as a primary target for Democrats to investigate or even impeach if they win congressional majorities, replacing the health secretary isn’t likely to be enough to restore public health. As healthcare policy experts Steven Grossman and Michael Miller recently wrote in MedPage Today, “even an outcome that brings more pro-vaccine members to Congress will still leave vaccines facing long-term existential threats at both the federal and state levels through regulatory and legislative proposals and actions. Heavy lifting from pro-vaccine policymakers and advocates will be essential over the next 2 years, but this need will likely stretch into 2029 and beyond.”

Amid the deluge of scandals pouring out of the Trump administration, the corruption, war and skyrocketing cost of living, the comeback of measles may not be top of mind for most voters. But every day that public health leadership ignores a spiraling crisis adds up to more people hospitalized, disabled and dead. If the midterms don’t bring some form of reckoning for MAHA and its assault on public health, we can expect to lose a lot more than the WHO’s elimination status.