Measles is surging in the U.S. — and outbreaks can cost millions

Measles outbreaks aren't just a public health threat. They can also be a financial burden on the U.S. — and the cost could only deepen as the once-eliminated disease spreads more widely.

The U.S. is expected to lose its official measles elimination status following a review by the Pan American Health Organization this week, after cases ratcheted to recent highs this year.

More than 5,100 measles cases have been reported nationwide in 2026 as of early November, marking the country's worst outbreak in more than three decades. Eight deaths associated with the disease have been confirmed by states so far in 2026: six in Pennsylvania , one in New York and one in Wisconsin .

The tool also estimates that 2025 measles outbreaks in the U.S. — which involved 2,289 confirmed cases nationwide – carried an economic cost of more than $37 million.

The estimates from the tool are not a definitive accounting of what the outbreaks actually cost. But it illustrates the hefty bill tied to the spread of a disease that can be prevented through vaccination, and the potential economic consequences of falling childhood immunization rates. CNBC previously reported on how the return of measles in the U.S. exposes weaknesses in the nation's public health system that raise concerns about the return of other eliminated diseases.

"We're starting to see a whole bunch of people who decided not to get vaccinated as kids or have never gotten exposed to measles because they benefited from herd immunity, who now make it into adulthood and risk potentially getting quite seriously ill and requiring very significant medical expenses, or dying at the hospital," Bryan Patenaude, a health economist at the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health, who helped develop the tool, said in an interview.

Measles outbreaks can trigger a costly public health response, even when many people who are exposed never become sick.

When a case is identified, public health officials must investigate the infection, identify and notify people who may have been exposed, coordinate with hospitals and schools, and sometimes organize vaccination campaigns to prevent further spread. Those efforts can divert staff and resources from other public health priorities.

Costs could differ heavily depending on the state.

Johns Hopkins' data includes national averages alongside state-specific inputs, including inpatient hospital costs and wages from government data or trusted health policy sources. In New York, for example, the average inpatient hospital stay is roughly $4,200 a day, while the minimum wage is $16 per hour.

The tool estimates that the 48 cases reported by New York in 2025 carried an estimated $1.1 million in costs, including nearly $749,000 in public health responses, $333,000 in productivity losses and roughly $24,500 in direct medical expenses.

Meanwhile, the 803 cases in Texas, the epicenter of the largest U.S. measles outbreak in 2025, carried estimated costs of nearly $13 million, according to the tool. That includes $9 million in public health costs, $4 million in productivity losses and around $288,000 in direct medical expenses.

The economic burden of measles extends beyond the costs of treating infected patients and organizing a public health response.

People who are exposed to measles may have to quarantine, even if they never develop symptoms. Parents can also be forced to miss work to care for sick or exposed children, while workers who contract the disease may lose wages during their recovery.

A 2025 study by Joey Mattingly, a pharmacist and health economist at the University of Utah, used published epidemiological and cost data to model the potential economic burden of a hypothetical 1,500-case outbreak. His analysis included direct medical expenses, public health spending and lost productivity, and examined how the estimates changed under different assumptions, including hospitalization rates.

The study estimated that the hypothetical outbreak could cost about $90 million, including roughly $26 million in productivity losses.

Mattingly estimated that each person who is quarantined could amount to roughly $300 in lost productivity alone.

That ripple effect is one reason Mattingly argues that the economic costs of outbreaks can quickly outweigh the investment required to vaccinate people against measles.

The financial burden can also fall unevenly across communities. While the costs of responding to an outbreak may be shared among local, state and federal agencies, Mattingly said the impact is often felt directly by local health departments.

"It's not like your health department is sitting around waiting for measles outbreaks," he said. "They're working, doing all these other things, and imagine having to just drop what you're doing because there's been a huge outbreak in the community."

Patenaude said the findings could help state and local health departments better anticipate the resources needed to contain outbreaks — particularly as measles cases continue to rise.

"It's not super expensive to treat and deal with a single case of measles compared to a single case of cancer," he said. "But if you have these outbreaks popping up and you're having to constantly divert resources that could be spent elsewhere by state and local health departments on measles, then you're going to wind up spending a lot of money very quickly."