A measles outbreak in Texas continues. Officials now report 58 cases, most in young children and ... [+] most ion unvaccinated people.
gettyThe number of cases of measles has increased to 58 in the South Plains region of Texas, according to data released by the Texas Department of State Health Services on Tuesday. This represents an increase from 48 cases reported on February 14. Fifteen cases have been in children under the age of 5. An additional 33 cases have occurred in children between the ages of 5 and 17. Thirteen individuals have been hospitalized. Another three cases have been reported in New Mexico. Health officials in Texas report that most of the infected people are unvaccinated or only partially vaccinated.
What Is Measles?Measles is a highly contagious, severe airborne disease. Typically, people with the disease exhibit a high fever, respiratory symptoms, conjunctivitis, and the tell-tale rash. These symptoms may be mild in some people but can be quite significant. According to the CDC, about 20% of unvaccinated people in the U.S. Who get measles require hospitalization. Measles is fatal in approximately one to three out of every 1,000 unvaccinated children. About one out of every 1,000 children will develop swelling of the brain, which can lead to long-term hearing and cognitive problems. Measles also has been associated with long-term defects in the immune system, leading to increased susceptibility to other infections later in life. And, according to the American College of Obstetricians and Gynecologists, measles infection during pregnancy can lead to increased risks of preterm delivery, low birth weight, and miscarriage.
Also called rubeola, measles is caused by the measles virus, a member of the morbillivirus family of viruses. Other pathogens in this group include canine distemper virus, which infects dogs, and rinderpest virus, which infected cattle and related ungulates. A global vaccination program led to the eradication of this disease, with the last reported case of rinderpest occurring in 2001.
Measles virus only infects humans. It is transmitted from person to person via respiratory droplets and is highly transmissible. Epidemiologists generally agree that the R-naught value of this virus in an unvaccinated population is 12-18. In other words, an infected person, on average, will infect an additional 12 to 18 people. This makes measles viruses one of the most contagious viruses known.
Signs and symptoms of disease usually appear about one to two weeks after a person is exposed to the virus. A rash usually becomes noticeable a few days after the onset of the initial symptoms. An infected person can transmit the virus to others beginning about four days before the rash appears and an infected person remains contagious for about four days after the rash first appears. Thus, to prevent the spread of disease, a person with measles should remain in isolation throughout this period.
The Measles VaccineMeasles can be almost entirely prevented by vaccination. The vaccine, administered in the U.S. As part of the Measles Mumps Rubella vaccine, consists of a weakened, or attenuated form of the virus. Upon injection, this attenuated virus replicates at low levels in a person, stimulating a robust immune response but not causing disease. A two-dose series is recommended, with the first dose being administered in children between the ages of 12 and 15 months and the second dose being administered around 5 years of age. The shots can be administered to older children and adults who were not previously vaccinated. Typically, maximal protection occurs about two weeks after the second dose.
This vaccine is incredibly effective, providing about 97% protection in fully vaccinated people. The result? A dramatic decline in the number of measles cases and deaths occurred during the second half of the 20thcentury. Indeed, measles was declared eliminated from the U.S. In 2020. Sustained spread no longer occurs.
The vaccine also is very safe. Common side effects are mild and may include soreness at the injection site and a low-grade fever. In rare cases, children may experience a seizure, but these seizures have not been associated with any long-term consequences. Studies repeatedly have found no link between the MMR vaccine and the development of autism.
Despite the safety and effectiveness of the MMR vaccine, not everyone can be vaccinated. For example, the vaccine may be contraindicated in people who are immunodeficient. This group could include people with HIV disease and people undergoing chemotherapy treatment. The vaccine also is not recommended for people who currently are pregnant.
What Comes Next?Because of the relatively low vaccination rate in Gaines County, the number of cases in this outbreak probably will continue to rise. Measles is highly contagious, so all unvaccinated people in the area remain at risk. People who do become infected should isolate until four days after the rash first appeared, to limit the spread to others. And unvaccinated people should get vaccinated. The Texas Department of State Health Services announced that vaccines are available at the South Plains Public Health District Clinic. The discomfort of a shot certainly is less than the severe consequences of the disease.
SEMINOLE, Texas — When Aganetha Unger pulled up her large, white van to the emergency measles testing site, several of her eight children were coughing.
"We had some sickness in the house, not very bad, but some fever, some cough," said Unger, who is Mennonite. One child, she said, had a fever of 103 degrees.
Her youngest getting tested was a 2-month-old, wrapped tightly in a pink blanket on her mom's lap. When the EMS team swabbed her nose, she didn't cry.
It was Thursday, eight days after the Texas Department of State Health Services first reported a measles outbreak on the rural, western edge of the state.
On Tuesday this week, the number of confirmed cases rose to 58, the state health department said. The majority of those cases are in Gaines County, which borders New Mexico. Four of the patients had been vaccinated. The rest are either unvaccinated or their status isn't known.
Most of the infections are in school-age kids, and 13 have been hospitalized.
Measles is one of the most contagious viruses in the world. The latest measles case count likely represents a fraction of the true number of infections. Health officials — who are scrambling to get a handle on the vaccine-preventable outbreak — suspect 200 to 300 people in West Texas are infected but untested, and therefore not part of the state's official tally so far.
The fast-moving outbreak comes as Robert F. Kennedy Jr. Takes the helm of the Department of Health and Human Services. Kennedy, a vaccine skeptic, has long sown distrust about childhood vaccines, and in particular, the measles-mumps-rubella (MMR) vaccine, falsely linking it to autism.
During his confirmation hearings, Kennedy said he was not anti-vaccine. "I am pro-safety," he said. "All of my kids are vaccinated, and I believe vaccines have a critical role in health care."
About 40 people showed up for measles testing this week at a mobile site in Seminole, Texas.NBC NewsHHS did not respond to a request for comment from Kennedy about the outbreak.
The Centers for Disease Control and Prevention can send in its experts to assist only if the state requests help. So far, Texas has not done so, the CDC said.
The CDC has sent about 2,000 doses of the MMR vaccine to Texas health officials at their request. However, most doses so far are being accepted by partially vaccinated kids to boost their immunity, rather than the unvaccinated.
Without widespread vaccination, experts say, the outbreak could go on for months.
Measles epicenterThe city of Seminole is the seat of Gaines County, Texas, and the epicenter of the current measles outbreak. It's located in a vast, flat region filled with ranchers and peanut and cotton farmers.
There's also a large Mennonite population, a religious sect that believes in "total separation from the outside world," according to the Texas State Historical Association. These Mennonites chose to settle in Gaines County, in part, for its lack of regulation on private schools. This includes vaccine mandates.
As of the 2023-24 school year, Gaines County had one of the state's highest vaccine exemption rates, at nearly 18%, according to health department data.
A woman and a young girl from the Mennonite community get tested for measles at a mobile testing site in Seminole, Texas. It takes at least 48 hours for results to come back.NBC News"We have a high, high number of unvaccinated," said Tonya Guffey, the chief nursing officer at Seminole District Hospital. "It's not that they're not educated. It's just what their belief is."
Guffey noted that many of the unvaccinated people in the area were Mennonite. "We educate, we encourage, we do what we can for the community, but it's their choice," she said.
The pandemic also appears to have driven down vaccination rates.
"We have some outside of that group of people that are unvaccinated, and the Covid vaccine did play a part in that," Guffey said.
Guffey, who was born and raised in Gaines County, has been in health care for over 30 years and said she's never seen a measles outbreak before. Still, she wasn't surprised by the size of the outbreak currently spreading across the county.
"With the large population of unvaccinated that we have," Guffey said, "it's not out of the numbers that you would expect."
'Hub' city concernsMeasles cases were limited to rural areas surrounding Lubbock, Texas, the largest city in the region, until Friday afternoon, when Lubbock Public Health confirmed its first case.
The "hub" city, as it's nicknamed, is where all of the big grocery and big box stores are.
People who live in Gaines County regularly head into Lubbock to shop and do other business. That includes a large number of unvaccinated people who may have been exposed to measles.
"Communities who don't vaccinate are not necessarily isolated to their area. They commute to Lubbock," said Dr. Ana Montanez, a pediatrician at Texas Tech Physicians in Lubbock. "By doing that, they're taking the disease with them."
Several of Montanez's young patients were exposed recently, she said, one just by sitting in the same clinic waiting room with another child who was later confirmed to have measles. That child had traveled from another county for care.
Two doses of the MMR vaccine are needed for virtually full protection against the virus. The first is given at around age 1, but the second isn't given until around age 5. That leaves kids slightly vulnerable for the several years that they are in between doses.
Doctors have the option of giving the second dose early, however, if a child has been exposed to the virus. That's what Montanez has done for a few of her vulnerable patients. She also continues to counsel families who aren't vaccinating their children about the benefits of the shots.
Young and vulnerableThe growing outbreak is worrisome to Carina Perez and her husband, Ben Ham, who are caring for a foster child they affectionately call "Muffin."
As the measles outbreak spreads in the Lubbock area, Carina Perez and her husband worry for the safety of their foster daughter, who has reactive airway disease, which makes her highly susceptible to any airborne viruses.NBC NewsThe 18-month-old girl has been eligible for only the first dose of the MMR vaccine so far. She was also born with several health problems, including reactive airway disease, which makes it hard to breathe if she catches any kind of respiratory virus.
Muffin has been admitted to the intensive care unit three times in her young life so far because of respiratory syncytial virus (RSV) and even the common cold.
"The smallest triggers get her pretty sick," Perez said. "We have to be very cautious about being out in public."
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What You Need to Know: With seasonal influenza (flu) cases and hospitalizations high, CDPH is reminding Californians it's not too late to get the flu vaccine. Vaccination is especially important for those at higher risk of severe illness including children, older adults and those who are immunocompromised.
SACRAMENTO – Seasonal influenza (flu) cases and activity are high in California, but it's not too late to get the flu shot to prevent severe illness and hospitalization. The California Department of Public Health (CDPH) recommends all Californians six months of age and older receive the flu vaccine to help protect against flu complications.
"Over the last several weeks, we have seen an increase in flu cases and hospitalizations," said Dr. Erica Pan, CDPH Director and State Public Health Officer. "As long as flu is circulating in our communities, it's not too late to get your flu vaccine, so we encourage all Californians who have not yet received their flu vaccine to get vaccinated. As a parent and a pediatrician, I ensure my family gets flu vaccine every year because I am confident the flu vaccine is safe and can help prevent serious illness like pneumonia and hospitalization."
Flu test positivity remains very high at 26.7% for the week ending February 8. This indicates a continued high level of flu activity across the state. This winter, flu has caused more hospitalizations than COVID-19 for all age groups. In addition, CDPH has received reports of 11 children who have had flu related deaths. This is a reminder that influenza can cause severe illness in people of all ages.
Additional influenza data is available on CDPH's Respiratory Virus Report.
At the same time, fewer Californians have received the seasonal flu vaccine than in years past. Vaccines are safe and effective at protecting against severe illness due to flu, and CDPH continues to recommend that all eligible individuals ages six months and older to receive a flu vaccine.
Scheduling: Schedule a vaccine appointment by visiting MyTurn.Ca.Gov, or contacting your local pharmacy or health care provider.
Cost: Flu vaccines are covered for most people through their health insurance plans, including Medi-Cal and regular health care providers. Those having difficulty obtaining vaccines can contact their health care provider or local health department for help finding a place to get immunized.
The Vaccines For Children (VFC) program is a federally funded program that provides vaccines at no cost to children (18 and younger) who might not otherwise be vaccinated because of an inability to pay. Contact your doctor to learn if they are enrolled in VFC or visit MyTurn to find a location based on your eligibility.
Protect Yourself and Your Loved Ones: In addition to vaccines, people can follow simple actions to prevent viruses from spreading this winter.
Get more information about respiratory virus prevention by visiting CDPH's Influenza (Flu) webpage.
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