A new analysis of measles vaccination trends finds that less than one-quarter of low- and middle-income countries (LMICs) currently meet measles elimination targets, leaving populations vulnerable to outbreaks, according to a study published in the International Journal of Infectious Diseases. As measles cases resurge worldwide, the findings highlight the persistent challenge of achieving and sustaining herd immunity. 

Of the 79 LMICs studied, only 17 (21.5%) achieved the World Health Organization’s elimination target of at least 95% coverage for receipt of the first dose of the measles vaccine. Coverage below 50%, which the researchers dubbed “critically low,” was identified in the Central African Republic (41%), Yemen (41%), Benin (44%), Papua New Guinea (44%), Madagascar (46%), and Sudan (46%).

Coverage for the second dose of the measles vaccine was even lower. Only 11 of the 79 countries (13.9%) reached the elimination target. Three countries—Benin, the Central African Republic, and South Sudan—reported no data for the second dose, suggesting that the vaccine isn’t part of their routine immunization schedules. 

LMICs have different vaccination barriers

Barriers to vaccination in LMICs differ from those in higher-income settings. In wealthier countries, hesitancy is often driven by safety concerns and misinformation, even as measles cases are rising and elimination status is threatened. 

LMICs, however, tend to face different roadblocks, including weak health infrastructure, supply chain issues, political instability, and competing health priorities. The disruption of immunization services during the COVID pandemic further widened existing immunity gaps. 

The substantial regional gaps in achieving global measles elimination require urgent attention, write the authors, who advocate for promoting vaccine uptake during perinatal care, engaging religious and community leaders to counter misinformation, and specialized approaches for countries with political instability to help bolster measles vaccination rates. 

New surveillance data published this week by the Centers for Disease Control and Prevention (CDC) show a slight decline in US tuberculosis (TB) cases in 2025.

The provisional report of data submitted to the CDC’s National Tuberculosis Surveillance System shows 10,260 TB cases were reported in 2025, with a corresponding rate of 3.0 cases per 100,000 population. That represents a 1% decline in cases and 2% decline in the national TB rate from 2024 to 2025. 

Twenty-six states and the District of Columbia reported decreases in cases. Among the states that reported a substantial decline in cases was Kansas, which saw an outbreak of TB in the Kansas City metro area in 2024 that was among the largest in the United States since the CDC began tracking the disease.

As with previous years, the vast majority (77%) of US TB cases were in non-US–born people, with a corresponding rate of 15.4 cases per 100,000. The rate for US-born people was 0.8 per 100,000. One-third of all cases involved people aged 25 to 44. Compared with 2024, TB cases declined among all age-groups except those 65 and older.

Pandemic-related increase in TB cases

The decline follows a steady rise in US TB cases from 2021 through 2024, an increase the CDC has said may be related to disruptions to TB services caused by the COVID-19 pandemic. Those disruptions, primarily in 2020, could have resulted in delayed diagnoses that were reported in subsequent years. Prior to the pandemic, US incidence of the disease, which sickens more than 10 million people a year globally and kills more than 1 million, had been steadily declining. 

The United States has one of the lowest TB rates in the world, and most US residents have a low risk of infection. But the CDC estimates that up to 13 million people in the country have latent TB, which means they’re infected but don’t feel sick and can’t transmit the disease. The agency says finding and treating people with latent TB is essential for treating and controlling the disease.

In the past week the United States Department of Agriculture Animal and Plant Inspection Service (APHIS) has tracked nine new H5N1 outbreaks in Indiana poultry facilities. 

The most recent three notifications came from Elkhart and LaGrange counties, and involved over 20,000 commercial duck meat birds. Earlier this week Adams County, Elkhart, and LaGrange counties also reported duck meat outbreaks affecting 3,000 to 8,600 birds.

The only commercial outbreaks outside of Indiana this past week came from Box Elder County, Utah, and Kanawha County, West Virginia, where 10 and 220 birds were affected, respectively. 

2 detections in red foxes 

In the past 30 days, H5N1 has been confirmed in 85 flocks, including 45 commercial and 40 backyard flocks, affecting a total of 10.10 million birds. Indiana accounts for 26 of the affected commercial flocks, and 11 affected backyard flocks.

Detections in wild birds continue to slowdown this week, with just 20 reports recorded by APHIS, including a Great Horned owl in Olmsted County, Minnesota, and several hawks across New York state. 

Finally, in mammal detections, a red fox in Nome County, Alaska, is confirmed to have been infected with H5N1, as has a red fox in Westchester County, New York.