Measles outbreaks in the United States could cost millions

Measles outbreaks not only pose a threat to public health. They can also pose a financial burden on the United States – and the cost is only likely to rise as the once-eliminated disease spreads more widely.

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

More than 5,100 cases of measles have been reported nationwide in 2026 as of early November, marking the worst outbreak the country has seen 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.

Based on this year’s case counts, a new tool developed by researchers at Johns Hopkins University estimates the economic cost of these outbreaks at nearly $83 million. This total includes $56 million in public health response costs, nearly $25 million in lost productivity and more than $1.8 million in direct medical expenses.

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

The costs go beyond treating people who get sick, and represent the resources spent by health departments to investigate and contain outbreaks, as well as wages lost when people have to miss work. The tool uses more recent, state-specific cost and funding data than an initial study by the researchers, which relied on historical costs of outbreaks.

The tool’s estimates are not a definitive account of the true cost of outbreaks. But it illustrates the high cost of spreading a disease that can be prevented through vaccination, and the potential economic consequences of falling childhood vaccination rates. CNBC previously reported how the return of measles in the United States reveals weaknesses in the country’s public health system that are raising concerns about the return of other eliminated diseases.

“We’re starting to see a whole group of people who decided not to get vaccinated as children or who were never exposed to measles because they had herd immunity, who are now reaching adulthood and at risk of becoming seriously ill and requiring very significant medical expenses, or dying in the hospital,” said Bryan Patenaude, a health economist at the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health, who contributed to the development of the tool, in an interview.

The costs of containing measles

Measles outbreaks can trigger a costly public health response, even if many exposed people never get 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. These efforts can divert staff and resources from other public health priorities.

Costs can vary greatly by state.

Johns Hopkins data includes national averages as well as state-specific data, including hospital costs and inpatient wages from government data or reliable health policy sources. In New York, for example, the average hospital stay for inpatients is about $4,200 per day, while the minimum wage is $16 per hour.

The tool estimates that New York’s 48 reported cases in 2025 resulted in estimated costs of $1.1 million, including nearly $749,000 in public health interventions, $333,000 in lost productivity, and about $24,500 in direct medical expenses.

Meanwhile, the 803 cases in Texas, the epicenter of the largest measles outbreak in the United States in 2025, resulted in estimated costs of nearly $13 million, according to the tool. This includes $9 million in public health costs, $4 million in lost productivity and approximately $288,000 in direct medical expenses.

The tool builds on a study published by Patenaude and other researchers in August, which examined the costs of measles outbreaks in the United States. Researchers reviewed published studies and government reports to compile historical estimates of medical spending and public health response costs in 18 states.

The paper estimates that outbreaks have resulted in a historical average cost of nearly $59,000 per case due to the public health response alone. The researchers also estimated how costs would change based on the size of the outbreak, separating the fixed initial response expenses from the additional costs associated with each new case.

“A lot of this is engaged up front, and that’s due to the human labor involved in contact tracing and all the different actors that have to sort of be mobilized to deal with the fact that there’s an outbreak,” Patenaude told CNBC. “This is a largely labor-related cost.”

This model estimated fixed costs of approximately $298,000 and approximately $16,300 for each additional case. But it relied on historical data, including a particularly large outbreak in 2019 in New York, where labor costs for contact tracing were high. The researchers also excluded productivity losses from this model because most of the historical studies they reviewed did not account for them consistently.

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

People exposed to measles may need to quarantine, even if they never develop symptoms. Parents may also be forced to miss work to care for sick or exposed children, while workers who contract the illness may lose wages while they recover.

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 outbreak of 1,500 cases. Its analysis focused on direct medical spending, public health spending and lost productivity, and examined how estimates changed under different assumptions, including hospitalization rates.

The study estimates that the hypothetical outbreak could cost about $90 million, including about $26 million in lost productivity.

These indirect costs can add up quickly because measles is highly contagious and a single infected person can expose dozens of others. These contacts may have to quarantine or miss work while health authorities determine whether they have been infected, incurring costs even if they never develop the disease.

Mattingly estimated that each person quarantined alone could represent about $300 in lost productivity.

If a single case of measles exposes 40 to 50 people who then must be quarantined, this could translate into an estimated $12,000 to $15,000 in lost productivity, even if none of those contacts become ill.

This ripple effect is one reason why Mattingly says the economic costs of outbreaks can quickly exceed the investment required to vaccinate people against measles.

“Even if you don’t get the infection, contact costs you,” he said. “And so it just shows that there’s this multiplication or exponential growth on the economic side that’s happening.”

The financial burden may also be unevenly distributed across communities. Although 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 imagining having to give up 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, especially as measles cases continue to rise.

“It is not very expensive to treat and treat a single case of measles compared to a single case of cancer,” he said. “But if these outbreaks appear and you have to constantly divert resources that could be spent elsewhere by state and local health departments to fight measles, you’ll end up spending a lot of money very quickly.”