A large number of measles cases are being missed by health authorities, a Centers for Disease Control and Prevention official said Tuesday, as the agency is now struggling to keep up with requests for support from states responding to outbreaks.
“We do believe that there’s quite a large amount of cases that are not reported and underreported,” said Dr. David Sugerman, senior scientist for the CDC’s measles response this year.
Sugerman’s remarks, at a meeting Tuesday of the CDC’s Advisory Committee on Immunization Practices, mark the first time that a CDC official has been made available by the Trump administration to field questions publicly about the record measles outbreak this year.
More than 700 measles cases have been reported nationwide so far this year, making 2025 the second-worst on record in decades. More than 560 of those cases occurred in Texas.
“In working very closely with our colleagues in Texas. In talking with families, they may mention prior cases that have recovered and never received testing, other families that may have cases and never had sought treatment,” he said.
Sugerman had been asked about the possibility that cases may have spread more widely than officials realized, after three deaths — two unvaccinated children in Texas, one unvaccinated adult in New Mexico — have been linked to the record outbreak in the region.
Measles would normally be expected to have a fatality rate of about one to three deaths out of every 1,000 children infected, the CDC says, so the number of deaths this year suggests there may be far more cases going uncounted.
“When one looks at the two deaths of school-aged children, and looks at the 41 cases that Lubbock has reported, where these cases I think are coming from, one comes up with a case fatality rate of about 4.8%, which is way above what we know that is the case fatality rate of measles,” said Dr. Edwin Jose Asturias, one of the committee’s members.
That adds up to an unlikely rate of deaths relative to the number of reported cases, Sugerman acknowledged.
The West Texas outbreak has been centered in a local Mennonite community. Underreported measles cases are not uncommon for close-knit communities where people are less likely to see a doctor when they are sick, he said.
“We do think there is under-testing, and therefore under-diagnosis and underreporting, which leads to a smaller denominator than likely,” said Sugerman.
More than 90% of current cases have been linked to the outbreak around Texas and neighboring states, he said. Genetic sequencing suggests that the Texas outbreak is also linked to outbreaks in Canada and Mexico, among members of the “same close-knit community.”
Texas is pulling resources and staff from other parts of its health department to respond to the measles outbreak. The CDC is now “scraping to find the resources and personnel needed to provide support to Texas and other jurisdictions,” Sugerman said.
“There are quite a number of resource requests coming in, in particular from Texas. There are funding limitations in light of COVID-19 funding dissipating,” he said.
The CDC previously deployed a team of 15 to Texas last month to aid in the response. That team’s deployment ended on April 1, the same day Health and Human Services Secretary Robert F. Kennedy Jr.’s massive layoffs rolled out at the CDC and other health agencies.
CDC’s original team included support from the agency’s National Institute of Occupational Safety and Health, or NIOSH, for helping health care facilities find ways to stop the spread of the highly contagious virus through improved ventilation, Sugerman said.
NIOSH was among the agencies that was largely eliminated by Kennedy’s layoffs. CBS News previously reported that multiple staff tasked to the CDC’s measles response had been laid off.
A new team of seven CDC responders are being deployed to Texas this week, Sugerman said.
Sugerman said the CDC is also exploring other ways to scale up the measles response, including expanding testing through wastewater surveillance for the virus in Texas and New Mexico. During COVID-19, the CDC worked with health departments to collect samples from sewer systems to spot undetected spread of the virus.
Health officials have worried that the failure to stop ongoing outbreaks of measles could put the U.S. on track to officially lose its status of having eliminated endemic community spread of the virus. Sugerman said that threshold could be crossed on January 20 next year.
“We will be tracking duration, working closely with our state and local partners to ensure we don’t cross the 12-month threshold and preserve our elimination status with ongoing spring and summer travel and congregate events,” said Sugerman.
Measles can be especially dangerous during pregnancy or early infancy, but there have been no stillbirths or miscarriages reported in the outbreak so far, he said. But health officials have dealt with “complicated exposures in hospitals” after pregnant women came to the hospital. There has also been one case of congenital measles — a newborn who contracted the virus from their mother. That child has recovered, he said.
“A significant risk in pregnant women that can develop measles and go on to have preterm labor, complicated deliveries, and then infants that that can have negative outcomes,” he said.
