New York Gov. Kathy Hochul declared a statewide disaster emergency Monday as measles cases rise in rural communities, adding to a nationwide outbreak that has made 2026 the worst year for the disease in the United States since 1991.

New York has recorded 108 confirmed measles cases this year through Oct. 3, including 92 since July 15 across 18 counties with under-immunized rural communities, according to the governor’s executive order. Seven cases have been reported in New York City, while 101 occurred elsewhere in the state.

The emergency declaration, which remains in effect through Nov. 4, expands the pool of health professionals who can respond to the outbreak. Registered nurses can order tests for suspected measles cases, while pharmacists and other authorized medical personnel can administer measles, mumps and rubella vaccines to children as young as 2. More than 1,000 MMR doses have been administered in rural areas since July 15.

The outbreak in New York comes as neighboring Pennsylvania has surpassed 1,000 measles cases, including 198 hospitalizations and five deaths. Pennsylvania is experiencing its largest measles outbreak in more than three decades, with many cases concentrated in rural communities.

Nationally, the Centers for Disease Control and Prevention had recorded 3,887 confirmed measles cases as of Oct. 1, making 2026 the worst year for measles in the United States since 1991, when more than 9,600 cases were reported. Measles was declared eliminated from the United States in 2000 after sustained vaccination efforts sharply reduced domestic transmission.

Hochul said the emergency measures are intended to increase access to vaccination and testing as the state works to contain the spread. The declaration marks the first statewide measles disaster emergency in the United States since the recent resurgence began.