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County, district and community-level measles transmission in the United States in 2013−2025

Nature Medicine, Published online: 18 August 2026; doi:10.1038/s41591-026-04561-w Multiscale modeling shows that measles transmission at the school level in the United States crossed the epidemic threshold after 2022−2023, a shift not detectable by county-level or district-level surveillance.

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