Texas doctors say they are worried about measles spreading to population centers in an outbreak the Centers for Disease Control and Prevention (CDC) expects to “expand rapidly”.
Two people have died, including a child, and at least 208 people have been sickened across west Texas and New Mexico after an outbreak of the vaccine-preventable disease took hold in rural Gaines county.
“It is worrisome,” said Dr Ron Cook, a family medicine specialist in Lubbock who serves as the county’s health authority. “Lubbock is the largest medical center, shopping center, etcetera between Albuquerque, New Mexico, and Dallas-Fort Worth”, and a place many from west Texas visit.
Residents of west Texas “come here to shop at the big box stores – Walmart, Costco, Sam’s and so forth,” said Cook, adding that Lubbock hospitals have already treated 38 measles patients from the outbreak.
The deaths are the first from measles in nearly a decade – and come as a test for the Trump administration’s new health secretary, Robert F Kennedy Jr, a longtime critic of vaccines.
Cook described an outbreak curve, familiar to those who watched infections rise and fall during the Covid-19 pandemic, that is still on the “incline”.
His concerns are shared by other local physicians, such as Dr Philip Huang, director of the Dallas county’s department of health and human services, who told local CBS news affiliate: “There’s concern that some of the people in west Texas are going to spread across the country. It’s not slowing down. This is not over, and there will be more cases.”
Cook said people also travel for maternity and pediatric care. He worries that the immunocompromised and babies could be exposed to measles in doctor’s waiting rooms.
“I personally don’t think I anticipated this, although I’m not surprised,” said Dr Tammy Camp, pediatric residency coordinator with Texas Tech University Health Sciences Center, also in Lubbock. When fewer people vaccinate, she said, “you always know you’re ripe for the possibility of an outbreak”.
Measles is one of the most contagious diseases known to medicine. Doctors often use the example of a room full of people to illustrate this: if 10 unvaccinated individuals enter and one has measles, nine leave infected.
The CDC expects the outbreak to continue spreading and potentially worsen with the upcoming spring and summer travel season. Although measles was once a common childhood disease, it is not without risks and general misery.
The most common symptoms include a characteristic top-down rash, fever, runny nose and red, watery eyes. Severe symptoms are less common but can be devastating: about one in a thousand infected children suffer severe brain swelling, called encephalitis, a condition that can lead to seizures, deafness and intellectual disability. Between one and three out of a thousand will die.
Additionally, scientists believe that measles infection can make people more vulnerable to secondary infections for months because it suppresses the immune system. Very rare conditions can also strike: about one in 25,000 children, or the equivalent of about four each year, suffer a degenerative neurological condition called subacute sclerosing panencephalitis. The disease presents years after infection with dementia-like symptoms that are eventually fatal.
The measles vaccine is 97% effective at preventing the disease. The vaccine’s side effects, while uncomfortable, are typically transient, and include fever and rash. Rarer side effects, such as febrile seizure, are nearly 10 times less common than children dying from measles infection, according to studies cited by the CDC.
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“Any child dying for a pediatrician is difficult, it’s tough,” said Camp, about how her residents have reacted to treating children with a largely avoidable disease. “Watching them have difficulty breathing, watching them have a rash, seeing them feel very irritable and fussy – and knowing it could be prevented – is hard and disheartening.”
The overwhelming majority of Americans still vaccinate their children, and many are calling Camp to vaccinate early, she said. The measles, mumps and rubella (MMR) vaccine is recommended for children ages 12 to 15 months old. However, measles is so infectious that vaccination coverage lower than 95% can allow its spread. That can make a place like Lubbock vulnerable, even when it is not the center of the outbreak.
The risk has been particularly acute since the pandemic, when more children missed routine vaccinations due to clinic and school closures, and anti-vaccine activists have gained significant political power, enjoying more donations during the pandemic.
RFK Jr, once the nation’s foremost vaccine critic, has responded to the Texas measles outbreak by downplaying the virus’s dangers and the vaccine’s efficacy, framing vaccination as a personal choice, and recommending good nutrition and vitamins.
“Then there’s the rhetoric about vitamin A and cod liver oil,” said Cook, who argues that it’s unhelpful to compare alternative treatments not tested in the US with a vaccine so effective it once helped eliminate measles in the US.
Camp noted that, to some degree, “vaccines are the victim of their own success”.
“When you have people who have never seen the disease,” she said, “it becomes easier to become fearful of the vaccine.”
