The number of measles cases in the United States has reached a multi-year high, so far in 2025, according to data provided by Johns Hopkins University’s outbreak response center.

As of July 7, there have been 1,277 reported cases of the virus, according to figures released by the Maryland-based medical school. That surpasses the previous record of 1,274 cases in 2019.

Johns Hopkins’ data showed 790 confirmed cases in Texas, which is the center of this year’s measles outbreak that has spread across multiple counties, and into New Mexico, where 95 cases have been reported so far.

Two elementary school-aged children in the epicenter in West Texas, and an adult in New Mexico, have died of measles this year. Officials said that none of them had received the measles vaccine.

There have been 27 outbreaks reported in 2025, with 88 percent of confirmed measles cases associated with these outbreaks, according to the most recent data from the Centers for Disease Control and Prevention.

As of July 1, the last available update, a total of 1,267 confirmed measles cases and three deaths were reported by 38 jurisdictions, according to the CDC.

Other U.S. states with active outbreaks—which the CDC defines as three or more related cases—include Arizona, Colorado, Georgia, Illinois, Iowa, Kansas, Michigan, Montana, New Mexico, North Dakota, Oklahoma, and Utah.

During the 1990 U.S. outbreak, measles cases surged to nearly 28,000 reported infections, which is the highest number in recent memory, according to the CDC. During that year, the majority of the cases were reported in California and Texas.

In 2024, 285 measles cases were reported nationwide, while 59 cases were reported in 2023, and 121 cases in 2022, according to CDC data.

There are three other large outbreaks in North America. The longest-running, in Ontario, Canada, has resulted in 2,212 cases from mid-October through June 24. The province logged its first death on June 5 in a baby who contracted congenital measles, but also had other preexisting conditions.

Another outbreak in Alberta, Canada, has sickened 1,169 as of Wednesday. The Mexican state of Chihuahua had 2,810 measles cases and eight deaths as of Wednesday.

Measles cases and outbreaks in the United States are often linked to a person who contracted the virus after traveling overseas, or who had recently entered the United States. In 2024, an outbreak, which included child cases, was associated with a Chicago facility that held numerous illegal immigrants.

Authorities say measles, considered highly infectious, generally shows up in two stages. In the first stage, most people develop a fever higher than 101 degrees Fahrenheit, a runny nose, watery red eyes, or cough. These symptoms generally start seven to 14 days after being exposed.

The second stage of measles starts about two to three days after the initial symptoms. Some people develop what is known as Koplik spots—tiny white spots—inside the mouth, according to the CDC.

Three to five days after the first symptoms begin, the telltale measles rash starts to appear on the patient’s face near the hairline, before it spreads downward to the rest of the body.

CDC and other health officials say that the best way to mitigate measles is to receive a vaccine, usually the measles, mumps, and rubella (MMR) shot.

The Associated Press contributed to this report.