The Minnesota Department of Health confirmed 10 new measles cases since Monday, raising the state’s total this year to 18.

“We have been worried about this all year,” said Dr. Chase Shutak, pediatrician and medical director at Children’s Minnesota in Minneapolis. “When the outbreaks began in Texas, all of us anticipated that it would eventually work its way up into our state.”

Shutak was referring to the outbreak in West Texas, which has reached 762 cases, resulting in 99 hospitalizations and two deaths.

Minnesota officials said one child has been hospitalized so far.

Most infections were reported among families who traveled within the US, with none of the children vaccinated against measles, mumps, and rubella.

Authorities did not clarify whether all patients were eligible for the vaccine, typically administered in two doses starting around age one.

Arizona is also struggling with a fast-growing outbreak near the Utah border, recording 59 confirmed cases and one hospitalization.

Most cases occurred in Mohave County, in the state’s far northwestern corner.

“You can safely say that we are actually a part of Northern Arizona’s outbreak,” said David Heaton, public information officer for the Southwest Utah Public Health Department. “There’s one town that straddles the state line, and all of our cases appear to be linked.”

Utah has identified 44 measles cases, largely among unvaccinated youth.

Five were hospitalized but have since recovered, Heaton said.

If the outbreaks persist through January, the US risks losing its measles elimination status—achieved 25 years ago.

The Centers for Disease Control and Prevention has reported 1,544 confirmed cases nationwide, with only 21 linked to travelers from abroad.

Despite ongoing federal disruptions, a CDC official said the agency’s outbreak monitoring remains unaffected by the government shutdown.

A recent NBC News review found vaccination rates have declined in over three-quarters of US counties since 2019.

Among states reporting measles-mumps-rubella coverage, 67% have insufficient levels for herd immunity.

Public health experts warn that complacency and politicization of vaccine policy have worsened the risk.

Texas’s outbreak began to subside only after the virus exhausted unvaccinated hosts.

“We got to a point where there was herd immunity within that under-vaccinated population,” said Katherine Wells, public health director for Lubbock, Texas.

She credited public education and isolation measures for helping contain the spread.

“People really listened to that messaging, which also helped to reduce exposures,” she said.

Measles symptoms include headache, fever above 104°F, cough, runny nose, red eyes, white mouth spots, and a spreading rash from scalp to legs.

While public health officials stress vaccination as the only reliable defense, the continuing spread reflects broader failures in US prevention strategy and declining trust in institutions meant to uphold it.