Texas public health officials say a measles outbreak has grown to 24 cases as of Feb. 11. Most of the patients are younger than 18, and all are unvaccinated. Nine patients have been hospitalized.
The Texas Department of State Health Services (DSHS) is monitoring the outbreak and expects additional cases.
Six of the measles cases are among children younger than 4 years, 16 cases are among children ages 5-17 years and two cases are among adults. All are residents of Gaines County, which had a nearly 18% vaccine exemption rate among kindergartners in the 2023-’24 school year, according to DSHS statistics.
“The measles outbreak in Texas is a reminder that horrible infections still exist. We just don’t typically see them because vaccines do their job and protect us from disease,” said Ari Brown, M.D., FAAP, founder of 411 Pediatrics and After Hours Care in Austin, Texas. “Pockets of under-vaccinated communities and drops in vaccination rates overall leave everyone at risk.”
Anti-vaccine, anti-science rhetoric leads parents to question the benefits and risks of vaccines, Dr. Brown said.
“It’s critical for all pediatricians to speak up and help them feel confident about protecting their kids by vaccinating them,” she said.
The AAP and the Centers for Disease Control and Prevention (CDC) recommend children receive the measles-mumps-rubella (MMR) vaccine at age 12-15 months and again at 4-6 years. Children can receive the second dose earlier if it is at least 28 days after the first dose. Each MMR dose lowers the risk of infection and severity of illness if infected.
“Measles outbreaks are seldom a big mystery. The virus is so highly contagious, with a reproductive number in the double digits,” said Peter J. Hotez, M.D., Ph.D., FAAP, co-director of Texas Children’s Hospital Center for Vaccine Development. “A decline in pediatric vaccine coverage below 90% can result in a substantial outbreak. I think it’s likely this measles epidemic will continue to grow. Between 2023 and 2024, we went from four to 16 measles outbreaks nationally. This number may increase again in 2025.”
The measles virus is transmitted by contact with infectious droplets or by airborne spread when an infected person breathes, coughs or sneezes. Measles virus can remain infectious in the air up to two hours after an infected person leaves an area.
Illness onset (high fever, cough, runny nose and red, watery eyes) begins a week or two after someone is exposed. A few days later, a rash breaks out as flat, red spots on the face and then spreads down the neck and trunk to the rest of the body. A person is contagious about four days before the rash appears to four days after.
Other measles symptoms may include small spots in the cheek area inside the mouth, diarrhea and ear infection. Measles can lead to pneumonia, swelling of the brain, deafness, intellectual disability and death.
Measles was rare in the United States, but outbreaks are occurring in areas where vaccination rates have fallen. Most children who get measles are not up to date on recommended vaccines or are not old enough to get measles vaccine.
The CDC measles website, which is expected to be updated monthly, reports 15 cases of measles as of Feb. 6 in five jurisdictions (Alaska, Georgia, New York City, Rhode Island and Texas). Last year, 285 measles cases (16 outbreaks) were reported by 33 jurisdictions across the United States, according to the CDC. For comparison, 59 measles cases (four outbreaks) were reported in 2023.
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