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Why Measles Outbreaks May Be the New Normal

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Why Measles Outbreaks May Be the New Normal

As the Trump administration moves to dismantle international public health safeguards, pull funding from local health departments and legitimize health misinformation, some experts now fear that the country is setting the stage for a long-term measles resurgence.

If federal health officials do not change course, large multistate outbreaks like the one that has torn through West Texas, jumping to neighboring states and killing two people, may become the norm.

We have really opened the door for this virus to come back,” said Dr. Thomas R. Frieden, a former director of the Centers for Disease Control and Prevention.

In order for an outbreak to occur in the United States, the virus must first be imported into the country, and it must reach a large, unvaccinated population.

Recent events have made both conditions seem increasingly likely, said Dr. William Moss, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.

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Efforts to control the spread of measles internationally have been disrupted by the Trump administration’s recent decision to withdraw from the World Health Organization, which runs a network of more than 700 laboratories that track measles cases in 164 countries.

The program — which helps to ensure prompt public health responses to emerging outbreaks — relies on the United States to fund its entire $8 million annual budget.

The funds for Gavi were not included on a list the State Department sent to Congress last week of programs it intends to continue to support. But the organization has yet to receive a formal grant termination letter, and its leadership is lobbying the administration to preserve the funding.

Both the W.H.O. withdrawal and the possible loss of Gavi’s funding are likely to cause a surge in measles cases overseas, increasing the likelihood that a U.S. traveler will bring the virus back into the country, said Dr. Walter Orenstein, a professor emeritus at Emory University and the former director of the National Immunization Program at the C.D.C.

People don’t understand that supporting global immunization not only is good for their countries, but for our country,” he said.

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This week’s layoffs at the C.D.C. included staff members who communicate with the public during infectious disease outbreaks and help craft campaigns to encourage vaccination.

Now communications will be centralized at the Department of Health and Human Services, under the control of health secretary Robert F. Kennedy Jr., a vaccine skeptic. The department did not respond to requests for comment.

Dr. Frieden, the former C.D.C. director, described the cuts as “a recipe for disaster.”

The national immunization rate for measles, which fell during the Covid-19 pandemic, has not rebounded to the 95 percent required to stem the spread of the virus in a community. That raises the odds that an imported case will land in a vulnerable population and ignite.

Roughly 93 percent of children in kindergarten had the M.M.R. shot in the 2023-24 school year. But vaccination rates are unevenly distributed; some communities have rates around 80 percent, offset by others where the figure is closer to 99 percent.

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Now that H.H.S. has moved to cut billions of dollars to local health departments, they may struggle to quash outbreaks early on, allowing the virus to hop to other unvaccinated communities. (A judge temporarily blocked the funding cuts after a coalition of states sued the Trump administration.)

During infectious disease emergencies, it is local health departments that investigate the source of the pathogen and track down anyone who might have been exposed so they can be quarantined.

The contact-tracing process is time consuming and resource intensive, especially for a virus as contagious as measles.

A fire is burning and we are at the same time shutting down all the fire departments,” said Jennifer Nuzzo, director of the Pandemic Center at the Brown University School of Public Health.

The current outbreak that began in West Texas shows no signs of slowing. There have been more than 480 cases in the area and 56 hospitalizations since late January. The outbreak has also spread to bordering states, sickening 54 people in New Mexico and 10 in Oklahoma.

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Genetic sequencing has suggested that the outbreak is also linked to 24 measles cases discovered in southwest Kansas.

Measles was officially eliminated in the United State in 2000. But the speed at which the Texas outbreak has grown and the fact that it has already jumped to other, under-vaccinated communities makes it very likely that the United States will lose that status, Dr. Nuzzo said.

Measles is no longer considered eliminated if a chain of infections continues for more than twelve months. Public health officials in West Texas have predicted the outbreak will continue for a year.

A large measles outbreak that spread through parts of New York State for nearly 12 months nearly cost the country its elimination status in 2019. The outbreak was contained in large part because of aggressive vaccine mandates, which helped substantially increase childhood immunization rates in the community.

“We just missed it by a hair,” Dr. Nuzzo said. “Where we are now is worse than that.”

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Mr. Kennedy has offered muted support for vaccination and has emphasized untested treatments for measles, such as cod liver oil. According to doctors in Texas, his endorsement of alternative treatments has contributed to patients delaying critical care and ingesting toxic levels of vitamin A.

Mr. Kennedy recently tapped a prominent figure in the anti-vaccine movement to work on a study examining the long-debunked theory that vaccines are linked to autism.

If the country does lose elimination status, Dr. Moss said, its unlikely that infection rates will resemble those of the pre-vaccine era, when measles infected nearly every child by age 15.

But it would be likely to mean more frequent and larger outbreaks that make life riskier for society’s most vulnerable: babies too young to be vaccinated, and immunocompromised people.

There are direct consequences — the health tolls, the long-term health impacts,” Dr. Nuzzo said. “Measles outbreaks are like just incredibly costly and disruptive.”

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“It’s also just an embarrassment. It puts the United States on par with some of the most resource-constrained settings in the world, and out of step with most high-income countries.”

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Video: Rescuers Mount a Likely Final Push to Save a Stranded Whale

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Video: Rescuers Mount a Likely Final Push to Save a Stranded Whale

new video loaded: Rescuers Mount a Likely Final Push to Save a Stranded Whale

Rescue crews mounted a likely final push to save a stranded humpback whale off the coast of Northern Germany on Friday. The large mammal, nicknamed “Timmy,” captivated the nation after it was stranded in shallow waters for weeks.

By Jorge Mitssunaga

April 17, 2026

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1,200% jump in kratom-related calls to poison control centers in last decade, analysis shows

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1,200% jump in kratom-related calls to poison control centers in last decade, analysis shows

Over the last decade, poison control centers around the country have received tens of thousands of calls from consumers of kratom products reporting adverse and life-threatening health effects, with researchers saying reports in 2025 reached a new level. California’s poison center is reporting similar findings.

Last month, researchers analyzed information from the National Poison Data System and found that between 2015 and 2025, poison control centers across the nation received 14,449 calls related to kratom. More than 23% of those calls, or 3,434, were made last year, according to a published report in the Centers for Disease Control and Prevention. That represents a more than 1,200% increase from 2015, when only 258 calls were reported.

Officers gather illegally grown kratom plants in 2019 in Phang Nha province, Thailand. The country decriminalized the possession and sale of kratom in 2021.

(Associated Press)

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Kratom is derived from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. It has a long history of being used for chronic pain or to boost energy and in the U.S., research points to Americans also using it to alleviate anxiety. In low doses, kratom appears to act as a stimulant but in high doses, it can have effects more like opioids.

But in the last few years, a synthetic form of kratom refined for its psychoactive compound, 7-hydroxymitragynine or 7-OH, has entered the market that is highly concentrated and not clearly labeled, leading to confusion and problems for consumers. The synthetic form gaining momentum in the market is sparking concern among public health officials because of its ability to bind to opioid receptors in the body, causing it to have a higher potential for abuse.

Los Angeles County leaders, meanwhile, have grappled with differentiating the two and regulating the products that come in the form of powder, capsules and drinks and have been linked to six county deaths. Sales of kratom and 7-OH products were banned in the county in November.

In reviewing the data, which did not differentiate whether callers had consumed natural or synthetic kratom, researchers set out to understand the effect of what they believe is a “rapidly evolving kratom market,” and highlight the role poison centers can play as an early warning surveillance system to detect new trends.

National Poison Data System findings

The data showed that over the last 10 years, 62% of the kratom-related calls to poison control centers were from people who said they consumed the drug by itself, and the other 38% were from people who combined it with another substance or substances.

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Those who consumed kratom with another substance combined it most frequently with one or a combination of the following: alcohol, opioids, benzodiazepines (like Xanax or Valium), cannabis and cannabinoids, stimulants and antidepressants.

The data also broke down hospitalizations related to kratom — adults who took it alone or in combination and experienced “adverse” health effects; and adults who took it alone or in combination and experienced more serious “moderate” or “major” health effects, including death.

Kratom powder products are displayed at a smoke shop.

Kratom powder products are displayed in a smoke shop in Los Angeles in 2024.

(Michael Blackshire/Los Angeles Times)

Hospitalizations for adults who had consumed kratom alone and experienced adverse effects increased from 43 in 2015 to 538 in 2025. For those who took it in combination and were hospitalized with an adverse health effect, the total jumped from 40 in 2015 to 549 last year.

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The numbers were even higher for hospitalizations where the health effects were more serious or fatal.

In 2015, there were 76 reports of people being hospitalized after taking kratom alone and experiencing a serious health effect or dying. By last year, that number had climbed to 919. The reports of serious health effects, including death, for those who took kratom in combination with another substance grew from 51 in 2015 to 725 last year.

The research does not break down kratom-related deaths by year but states that there were 233 deaths over the 10-year study period, or just over 3% of all 7,287 serious medical outcomes. Of the total number of kratom-related deaths, 184 cases involved the consumption of multiple substances.

What California’s poison control system found in its state data

The California Poison Control System is currently reviewing its data concerning kratom-related calls but an initial analysis shows parallels to the national report, said Rais Vohra, medical director of the state poison control system.

“We have about 10% of the national population and about 10% of the national call volume with poison control,” Vohra said. “And so, not surprisingly, we were able to identify over 900 cases of calls related to kratom in that same period.”

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Local researchers are still deciphering the state data but they too have found that kratom-related calls are climbing.

“It’s accelerating, which I think is one of the main points of the [published] report,” Vohra said.

A majority of calls received by poison control come from healthcare facilities where “presumably someone has a problem … severe enough to warrant calling 911 or going to the emergency room, and that’s when our agency gets involved,” Vohra said.

Kait Brown, clinical managing director for America’s Poison Control Centers, said the fact that kratom and 7-OH are federally unregulated products sold online, in gas stations and smoke shops gives people across the country easy access.

And while kratom enthusiasts maintain that it has been used in its natural form for hundreds of years, “there are new formulations that are a little bit different than how people have used it, at least historically,” said William Eggleston, a pharmacist and the assistant clinical director of the Upstate New York Poison Center in Syracuse.

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People are no longer consuming kratom only as a powder or capsule but also in the form of an energy shot or extract; it’s similar for synthetic, more concentrated 7-OH products.

When regional poison centers compare their findings and experiences with the analysis of calls in the National Poison Data System, Eggleston said, “undeniably there is an increase in calls related to kratom.”

“But when you put it in the bigger perspective of all the calls … this is still a very small percentage of what we’re dealing with on a day to day basis,” he said.

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Video: NASA Astronauts Discuss Surprise Moment on Artemis II Mission

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Video: NASA Astronauts Discuss Surprise Moment on Artemis II Mission

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NASA Astronauts Discuss Surprise Moment on Artemis II Mission

During a NASA news conference on Thursday, the Artemis II commander Reid Wiseman recapped a startling moment from the mission: A smoke detector went off in the spacecraft tens of thousands of miles away from Earth.

We had a few cautions and warnings that came up from time to time. And those — always — they always get your attention. We had a smoke detector go off on the next to last day. I mean, you want to get somebody’s attention really quick, make the fire alarm go off in your spacecraft when you’re still about 80,000 miles from home. And that starts off an automated sequence of shutting down the ventilation and the power system. And that was — it was tense. It wasn’t scary, but it was tense for a few minutes until we got things reconfigured.

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During a NASA news conference on Thursday, the Artemis II commander Reid Wiseman recapped a startling moment from the mission: A smoke detector went off in the spacecraft tens of thousands of miles away from Earth.

April 16, 2026

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