US Measles Outbreak Surges Towards 100 Cases

An outbreak of measles in the US is approaching 100 cases as it spreads into more heavily populated areas, predominantly affecting children and adolescents.

First detected in late January as two schoolchildren were hospitalized for the disease in Gaines County, Texas, the highly infectious virus has since crossed state borders into New Mexico and Georgia, leading to fears of missing cases.

A list of current exposure sites in West Texas can be found here.

At least 23 of the 93 known cases have been hospitalized so far. More than 80 percent of cases are individuals under the age of 19, leading to the shutdown of several private schools.

"This is the tip of the iceberg," Rekha Lakshmanan suspects, telling Amy Maxmen at KFF Health News: "We are going to see more kids infected. We will see more families taking time off from work. More kids in the hospital."

Measles can spread before the emergence of symptoms, which can include fever, cough, runny nose and irritated eyes, white spots in the mouth, and a red flat skin rash about three days after initial symptoms. In the worst cases, the highly infectious virus can cause serious health complications including pneumonia, blindness, brain damage, and death.

"Measles is a highly contagious airborne disease spread by contact with an infected person through coughing and sneezing," warns Hays County Local Health Authority physician John Turner in a public health alert. "Texas is currently experiencing the largest outbreak of measles in decades."

The measles virus, Morbillivirus hominis, can survive in the air for hours, allowing each infected person to spread it to an average of 18 other individuals.

Once in a person's airways, the RNA molecule targets their immune cells, duplicating within them and spreading itself through the lymphatic system. Here, it not only suppresses immunity but destroys the body's defenses against infections by wiping out the immune system's memory.

This 'memory loss' can continue for up to three years, leaving people vulnerable to secondary infections like pneumonia – the main cause of death in children with measles.

Years after recovery, the infection can still trigger a rare but fatal condition in the central nervous system called subacute sclerosing panencephalitis.

There is no specific treatment for the disease, but vaccination programs have successfully suppressed the spread of measles for decades, leading to an official elimination of the disease in the US at the turn of the century. Prior to the vaccine's development, some 48,000 hospitalizations and around 500 deaths occurred each year as a direct result of infections.

Health authorities have been warning for years that a decrease in vaccine uptake would lead to greater outbreaks of measles, a reality that is currently unfolding around the world. Measles outbreaks increased by 45 times in Europe between 2022 and 2023.

Most of those who have been infected in the current US outbreak are unvaccinated. Gaines County is an area with one of the lowest vaccine rates in Texas. Almost 20 percent of parents of young children have filed for vaccine exemptions in the region.

Health officials in Texas are running mobile testing units in schools and pop-up vaccine clinics to attempt to get ahead of the disease, while also facing increasing health policy obstacles to widescale vaccination.