The U.S. declared measles eliminated in 2000 "thanks to a very high percentage of people receiving the safe and effective measles, mumps, and rubella vaccine," the CDC said, but now U.S. coverage among children of kindergarten age is below the 95 percent coverage target, which creates a higher risk for outbreaks of the virus.

This is the tip of the iceberg,” said Rekha Lakshmanan, chief strategy officer for The Immunization Partnership in Houston, a nonprofit that advocates for vaccine access. “I think this is going to get a lot worse before it gets better.

The measles outbreak in Texas has escalated sharply to 90 cases as health officials worry about the spread to more communities.