Canada has lost its measles elimination status, said the Pan American Health Organization (Paho) on Monday, after failing to curb an outbreak of the virus for 12 consecutive months.

Because Canada is no longer deemed measles-free, the Americas region as a whole has lost its elimination status, although individually the other countries are still considered to have stamped out the disease.

The US, however, risks losing its status as well if it does not stop an ongoing outbreak by January. Related cases have now been reported in Utah, Arizona, and South Carolina.

Canada's outbreak began last October, with health officials attributing it to fewer people being vaccinated against measles.

At a news conference on Monday, Paho officials appealed to Canadian governments and the public to ramp up vaccinations, noting that 95% of the population needs to be immunised to stop the spread of measles.

This loss represents a setback, but it is also reversible, said Dr. Jarbas Barbosa, the health organization's director.

The Public Health Agency of Canada stated that it is collaborating with Paho and regional health authorities to improve vaccine rates and strengthen data sharing. Prior to Monday, Canada had been declared measles-free for three decades. It can regain its elimination status if it can curb the spread of the measles strain associated with the current outbreak for at least 12 months.

The country has reported more than 5,000 measles cases in 2025, with most of them in the provinces of Ontario and Alberta. That is three times the 1,681 cases reported in the US, despite Canada's much smaller population.

The bulk of the outbreak has been in under-vaccinated communities, Canadian health officials have said. Vaccination rates in Alberta, one of the provinces hit hard by the outbreak, are lower than the 95% threshold, according to provincial data.

One region, the South Zone, which includes Calgary, reported only 68% of children under the age of two were immunised against measles as of 2024.

The MMR vaccine is the most effective way to combat the virus, and is 97% effective while also immunising against mumps and rubella.

Canadian immunologist Dawn Bowdish highlighted various reasons behind the low vaccination rates, including lack of access to general practitioners, the absence of a national vaccination registry, and the spread of misinformation.

Bowdish emphasized the need for more public health outreach in hesitant communities, noting, It highlights how many of our systems broke down to get us to this point.

The Americas was the first region globally to be declared measles-free, starting in 2016, but that status was briefly lifted after outbreaks in Venezuela and Brazil. Both countries regained elimination status in 2024.

In addition to Canada, the US and Mexico are also seeing surges in measles cases, with Mexico ranking among the top 10 countries with the largest outbreaks, according to the US Centers for Disease Control and Prevention.