The first-ever World Cup match in Dallas featuring the Netherlands and Japan did not disappoint. Over the course of the match, before about 70,000 fans at AT&T Stadium, the Dutch team took the lead twice, but the Japanese squad clawed back to tie each time. The clash between the two powerhouses ended in a draw, 2-2, with both teams advancing. But on Monday, each team’s hopes and dreams of football glory came to an end when Japan was eliminated by Brazil, 1-2, while the Netherlands lost to Morocco, 2-3, in a penalty shootout.
FIFA, soccer’s international governing body, expected more than five million fans to travel to North America and spread out across the United States, Canada, and Mexico. Seventy-eight matches are scheduled to take place in the U.S. Just three days ago, the group stage of the 2026 World Cup broke the all-time attendance record, previously set in 1994, with 4.6 million fans attending—and many of those ecstatic fans were likely doing some coughing and sneezing.
In 2025, the United States had its highest number of measles cases since 1992, with 2,228 reported cases.
The World Cup creates the kind of close-contact environment that makes federal, state, and local public officials nervous. With fans gathering in stadiums and at watch parties across North America, they know that the games could be an incubator for highly contagious respiratory diseases like measles.
In 2025, the United States had its highest number of measles cases since 1992, with 2,228 reported cases. The virus came roaring back in Texas last year when the state experienced the country’s largest outbreak since 2000 when the Centers for Disease Control and Prevention (CDC) declared measles eliminated in the U.S. Between January and August, 762 people came down with measles. In the West Texas measles outbreak, two girls, ages six and eight, died during that period. Currently, Pennsylvania is experiencing a six-county outbreak, and the country is on track to surpass this 33-year high with 2,134 reported cases as of June 30, 2026, according to CDC figures.
The World Cup adds an additional layer of stress. “[Measles] is so highly, easily transmitted,” Dr. Philip Huang, the director of Dallas County Health and Human Services (DCHHS), told the Prospect. “The few cases that we get, sometimes, are from that international travel.”
To get out in front of the health risks, Dallas County has invested in public awareness campaigns and updated surveillance and testing strategies informed by the pandemic. “We’ve been doing a lot since COVID-19 with modernizing our data information systems, [and] public health data systems,” Huang says. The department also tests wastewater and sets mosquito traps in a variety of locations around Dallas County, such as Dallas Fort Worth International Airport, to test the biting insects that can carry the West Nile, Zika, and Chikungunya viruses.
DCHHS employs “syndromic surveillance,” an epidemiological strategy which relies on hospital data. Essentially, the DCHHS and its hospital partners look at patients’ symptoms to determine whether there is a connection to a large public event, such as the World Cup. Dr. Huang and his team receive reports of conditions through hospital electronic health record systems that they monitor in real time. Such information is crucial to stopping an outbreak. By monitoring patient symptoms, epidemiologists can quickly identify the size, spread, and tempo of an outbreak even before formal laboratory tests or diagnoses confirm for officials that they may have a major health emergency on their hands.
But robust disease public-health surveillance programs and strategies have been complicated by the politicization of vaccinations and epidemiological advances. During the 2025 West Texas measles outbreak, Texas Gov. Greg Abbott (R) and local lawmakers in the affected areas did not mention the measles outbreak in press conferences, nor did they encourage people to get vaccinated. This bystander behavior likely explains why, even though two school-aged children had already died, state lawmakers passed a measure that made it easier for parents to waive vaccination requirements for their children attending public schools.
In November of that same year, about 1,000 people attended a conference in Austin that disseminated misinformation around vaccines. The conference host was Children’s Health Defense, a nonprofit founded by none other than Health and Human Services Secretary Robert F. Kennedy Jr., a leader of the anti-vaccine movement.
The Trump administration also weakened the CDC when DOGE fired hundreds of employees in 2025. Among those fired were around 70 Epidemic Intelligence Service (EIS) officers, also known as “disease detectives,” who respond to domestic and international emerging disease outbreaks. Ironically, those same disease detectives who were laid off were called back to help combat the West Texas outbreak.
Together, anti-vaccination activism and federal layoffs have contributed to declining vaccination rates across the country and especially in Texas.
Together, anti-vaccination activism and the federal layoffs have contributed to declining vaccination rates across the country and especially in Texas. According to a 2025 Yale School of Public Health study, 95 percent of a given population must be vaccinated to keep measles at bay. In Texas, for example, 13 counties have reported vaccination rates below 85 percent.
Federal funding cuts have also created an epidemic of trouble for Texas public-health officials. Kennedy slashed approximately $12 billion in federal grants. Of that amount, more than $11 billion, which had been distributed by the CDC, had been used by states for infectious disease management. The White House also cut COVID-19 funding used for disease surveillance and vaccinations for children and insured adults.
“[The federal government] said COVID is not an issue [any longer], but the funds weren’t just used for COVID. During the middle of our measles outbreak in West Texas, we were using it for vaccinations, and we had even scheduled some events at schools that had low vaccination rates in the kids,” Huang says.
Even though the Trump administration has upended disease surveillance efforts, the DCHHS, like state and local-level public-health departments across the country, stepped up.
The DCHHS has ramped up inspections of new food trailers and other vendors serving fans. Huang and his team have also prepared a medical reserve team and recruited volunteers who are staffing cooling stations at the Fair Park Fan Zone.
Public awareness regarding health risks is a multilingual endeavor in the Lone Star State, with the Texas Department of State Health Services (TDSHS) and the DCHHS distributing flyers in six languages instructing people on how to protect their health. These instructions describe measures to keep safe from mosquitoes and recommended keeping up-to-date on their vaccinations—including those against measles. “We have to be nimble and try to adapt the best that we can,” Huang says.
So far, no measles outbreaks related to World Cup host cities have been reported, according to the CDC’s Outbreak Dashboard. The final game takes place at MetLife Stadium in East Rutherford, New Jersey, on July 19.
