The U.S. surpassed 1,000 measles cases Friday, even as Texas posted one of its lowest counts of newly confirmed cases since its large outbreak began three months ago.

Texas still accounts for the vast majority of cases in the U.S., with 709 confirmed as of Friday in an outbreak that also spread measles to New Mexico, Oklahoma and Kansas.Two unvaccinated elementary school-aged children died from measles-related illnesses in the epicenter in West Texas, and an adult in New Mexico who was not vaccinated died of a measles-related illness.

Other states with active outbreaks — which the CDC defines as three or more related cases — include Indiana, Michigan, Montana, Ohio, Pennsylvania and Tennessee.

North America has two other ongoing outbreaks, all of which are the same measles strain. One outbreak in Ontario, Canada, has resulted in 1,440 cases from mid-October through May 6, up 197 cases in a week. And the Mexican state of Chihuahua had 1,041 measles cases and one death as of Friday, according to data from the state health ministry.

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.

As the virus takes hold in U.S. communities with low vaccination rates, health experts fear that spread could stretch on for a year. Here’s what else you need to know about measles in the U.S.

How many measles cases are there in Texas?

There are a total of 709 cases across 29 counties, most of them in West Texas, state health officials said Friday. The state confirmed only seven more cases since its update Tuesday.

The state also added one hospitalization to its count, for a total of 92 throughout the outbreak.

State health officials estimated about 1% of cases — fewer than 10 — are actively infectious. Fifty-seven 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 had 403 cases since late January — just over 1.7% of the county’s residents.

The April 3 death in Texas was an 8-year-old child, according to Health Secretary Robert F. Kennedy Jr. Local health officials 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 the child was 6.

How many measles cases are there in New Mexico?

New Mexico added four cases Friday for 71 total. Seven people have been hospitalized since the outbreak started. Most of the state’s cases are in Lea County. Three are in Eddy County, two in Doña Ana County and one in Chaves County. Curry County logged its first case this week.

An unvaccinated adult died of measles-related illness March 6. The person did not seek medical care.

How many cases are there in Oklahoma?

Oklahoma held steady with a total of 14 confirmed and three probable cases as of Friday.

The state health department is not releasing which counties have cases, but Cleveland, Oklahoma and Sequoyah counties have had public exposures in the past couple of months.

How many cases are there in Kansas?

Kansas has a total of 48 cases across eight counties in the southwestern part of the state, with one hospitalization. Most of the cases are in Gray, Haskell and Stevens counties.

How many cases are there in Indiana?

Indiana has eight cases, all of them in Allen County in the northeast part of the state. The cases have no known link to other outbreaks, the Allen County Department of Health has said.

How many cases are there in Michigan?

Michigan has nine confirmed cases of measles, with an outbreak of four connected cases in Montcalm County in the western part of the state that state health officials say is tied to the Ontario outbreak.

How many cases are there in Montana?

Montana added three new measles cases in the last two weeks, bringing the total to eight. The state’s outbreak started in mid-April in southwestern Gallatin County — Montana’s first measles cases in 35 years. Health officials didn’t say whether the cases are linked to other outbreaks in North America.

How many cases are there in North Dakota?

North Dakota has nine cases of measles as of Tuesday. The state hadn’t seen measles since 2011, health officials said.

All are in Williams County in western North Dakota on the Montana border. The state health department says three of the confirmed cases are linked to the first case — an unvaccinated child who health officials believe got it from an out-of-state visitor.

The other five cases were people who were not vaccinated and did not have contact with the other cases, causing concern about community transmission. The state health department said four people diagnosed with measles attended classes while infectious at a Williston elementary school, middle school and high school.

How many cases are there in Ohio?

Ohio has 34 measles cases and one hospitalization, according to the Ohio Department of Health. That count includes only Ohio residents.

The state has two outbreaks: Ashtabula County near Cleveland has 16 cases, and Knox County in east-central Ohio has 20 — 14 among Ohio residents and the rest among visitors.

Allen, Cuyahoga, Holmes and Defiance counties have one case each.

How many cases are there in Pennsylvania?

Pennsylvania has 15 cases overall in 2025 as of Friday, including international travel-related cases in Montgomery County and one in Philadelphia.

There were eight measles cases in Erie County in far northwest Pennsylvania in late April; the county declared an outbreak in mid-April.

How many cases are there in Tennessee?

Tennessee had six measles cases as of early May. Health department spokesman Bill Christian said all cases are the middle part of the state, and that “at least three of these cases are linked to each other” but declined to specify further. The state also did not say whether the cases were linked to other outbreaks or when Tennessee’s outbreak started.

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

Measles cases also have been reported in Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Illinois, Kentucky, Louisiana, Maryland, Minnesota, Missouri, New Jersey, New York, Rhode Island, Vermont, Virginia and Washington.

Cases and outbreaks in the U.S. are frequently traced to someone who caught the disease abroad. In 2019, the U.S. saw 1,274 cases and almost lost its status of having eliminated measles.

What do you need to know about the MMR vaccine?

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

Getting another MMR shot as an adult is harmless if there are concerns about waning immunity, the CDC says. People who have documentation of receiving a live measles vaccine in the 1960s don’t need to be revaccinated, but people who were immunized before 1968 with an ineffective vaccine made from “killed” virus should be revaccinated with at least one dose, the agency said.

People who have documentation that they had measles are immune, and those born before 1957 generally don’t need the shots because so many children got measles back then that they have “presumptive immunity.”

Measles has a harder time spreading through communities with high vaccination rates — above 95% — due to “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.

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?

There’s no specific treatment for measles, so doctors generally try to alleviate symptoms, prevent complications and keep patients comfortable.

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