Measles Outbreak in Texas Suggests a Growing Threat -

Measles — a highly contagious and potentially life-threatening respiratory virus that is often characterized by a blotchy rash — is spreading fast in rural Texas, with some other states also seeing an uptick in cases.

On Tuesday, the Texas Department of State Health Services reported that 58 infections had been identified in five counties. Thirteen of those patients have been hospitalized.

The measles virus also appears to be present in Lea County, New Mexico, which borders Gaines County, Texas, the center of the outbreak. The case count in Lea County jumped from three last week to eight this week.

So far this year, incidents of measles have also been found in Alaska, Georgia, New York, and Rhode Island.

More Measles Cases Expected in the Weeks Ahead

Health authorities warn that many more people are likely to fall sick with measles in the weeks ahead.

“Measles is the most contagious infectious disease known in humans,” says virologist Gregory Poland, MD, president of the Atria Research Institute in New York City and a spokesperson for the Infectious Diseases Society of America. “If you are not immunized and walk into a room with somebody who has the measles, 12 hours later you almost certainly will develop the illness.”

The measles virus spreads through the air from coughs or sneezes, and it can linger in a room, posing a threat for up to two hours after a sick person has left, according to the Centers for Disease Control and Prevention (CDC).

If exposed, unvaccinated people have a 90 percent chance of contracting the virus, according to the World Health Organization. People who have the virus are contagious for up to four days prior to the onset of the measles rash, as well as for four days afterward.

A Warning Sign of an Undervaccinated Population

The rise in cases is a troubling turnaround for a disease that the United States declared officially eliminated 25 years ago, thanks to a widely followed vaccination program.

About 9 out of 10 measles infections are among those who are not vaccinated or whose vaccination status is unknown. The vaccine is estimated to be about 97 percent effective in preventing infection.

For Deborah Fuller, PhD, a professor of microbiology and a vaccine researcher at the University of Washington School of Medicine, the spike in measles is especially worrisome because it indicates a drop in vaccination rates and suggests that outbreaks of other vaccine-preventable diseases may be coming our way.

“It’s sort of the harbinger that signifies vaccination rates have declined below the level needed to protect the population,” she says.

A CDC study from the fall of 2024 showed that national kindergarten coverage with state-required vaccinations declined from about 95 percent during the 2019–20 school year to about 93 percent during the 2022–23 school year. The researchers concluded that this drop in vaccinations could be “setting the stage for accumulation of clusters of undervaccinated children, which can lead to outbreaks.”

“Because measles is so infectious, 95 percent of a community needs to be vaccinated in order to stop transmission and create herd immunity,” says Catherine Troisi, PhD, a professor of management policy and community health at the UTHealth Houston School of Public Health. “However, there can be pockets of unvaccinated [individuals] even when the larger community’s immunization rate is higher, and this can result in measles outbreaks.”

Who Should Get the Measles Vaccine?

The CDC recommends that all children get two doses of the MMR (measles-mumps-rubella) vaccine, with the first dose coming when they’re between 12 and 15 months old and the second dose when they’re between 4 and 6 years old.

Teens and adults are advised to check with their healthcare provider to make sure they are up to date on their MMR vaccination.

The National Foundation for Infectious Diseases adds that all adults born in 1957 or later who have not been vaccinated or have not had measles should be immunized. If you are not sure whether you have been vaccinated, know that it is considered safe to get another measles vaccine.

Most people who have received two doses of the MMR vaccine do not need a measles booster shot, but some specific individuals may benefit, such as those who have undergone certain treatments for cancer and have lost some immunity, according to Dr. Fuller.

“Luckily the measles virus does not mutate to the extent that new vaccines are needed,” adds Dr. Troisi.

Measles Can Make You Extremely Sick

The health effects of measles can be devastating and even fatal in some cases, according to Dr. Poland.

Common symptoms, which typically appear 7 to 14 days after infection, include:

A distinct rash that usually starts on the hairline and moves down to the face and upper neck. It then spreads to the rest of the body, including the hands and feet. On lighter skin, the rash appears red. On darker skin, the rash can be hard to see, though it may appear purple or darker than the surrounding skin.
High fever that may spike to more than 104 degrees F
Cough
Runny nose
Red, watery eyes
Tiny white spots (called Koplik spots) that may appear inside the mouth two to three days after other symptoms begin

There is no cure for measles, but the virus typically runs its course and clears in about 10 to 14 days.

Common complications are ear infections and diarrhea, but more severe outcomes can develop, including pneumonia and encephalitis (brain swelling), which may result in permanent brain damage.

The virus can also cause direct damage to the inner ear, resulting in deafness. Persistent presence of the virus in the brain after infection can result in subacute sclerosing panencephalitis, a rare form of progressive brain inflammation that is nearly always fatal.

One to three out of every 1,000 children infected with measles will die from complications of the disease. One in five unvaccinated people who get measles will require hospitalization.

Reversing a Downward Immunization Trend

Before the vaccine was introduced in 1963, the U.S. recorded an average of 500,000 measles cases and nearly 500 deaths per year.

Compare that to the period from January 1, 2020 to March 28, 2024, when a total of just 338 U.S. measles cases and zero deaths were reported.

Even as the numbers remain relatively low, health officials are concerned about the current case count inching up.

“I think there’s kind of an anti-vaccine skepticism in our culture right now, and vaccination is not being given its proper perspective by health authorities in our current climate,” says Poland. “This is a terrible disease and there is no treatment for it. There is, however, a near perfect preventive for it, and that’s the vaccine, and once you have the shot, you’re pretty well set for life.”

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