TRI-COUNTY — A child died of measles in a Lubbock hospital, state officials reported on February 26. The fatality is the first measles death in the United States in almost a decade. It comes amid a rapidly spreading outbreak that has infected at least 124 people and hospitalized 18 in Texas and New Mexico, with two confirmed cases in Ector County as of Thursday.
Dr. Sarah Zate, a pediatrician at Big Bend Regional Medical Center, expressed concern that the outbreak of measles — a violently infectious and potentially fatal disease — could spread to the Big Bend region. While Presidio and Jeff Davis county schools have measles immunization rates above 99%, Brewster County’s rates are troublingly low. Last year, the percentage of students with measles vaccinations in Alpine ISD — by far the largest school district in the county — dropped to around 95%, the minimum rate sufficient to protect a population against the measles. According to Zate, these numbers may underestimate vaccinations in the area because school district data excludes young children and home-schooled kids, and adult vaccination rates are unknown. “We’re considered a likely hotspot,” Zate said. “We are right on the razor’s edge.”
Gaines County, where the outbreak started in a Mennonite community, has one of the lowest vaccination rates in Texas. According to state health data, around 18% of kindergartners in Gaines received a non-medical vaccine exemption last year, meaning almost one in five students have not received a measles vaccine. While an outlier, Gaines County is not an anomaly. Since the Texas Legislature eased school vaccine requirements in 2003, vaccination rates have decreased dramatically, and today one out of six Texas school districts have measles vaccination rates below the 95% threshold needed for herd immunity.
Though easily avoided by vaccination, measles is a highly infectious disease with potentially serious complications. A single person with the measles usually spreads it to between 12 and 18 people, and infectious particles can hang in the air for two hours, making social distancing ineffective. “If you’re picking up your apples in the produce section, then I come an hour and a half after you and breathe in that air that you breathed out, I will get the measles if I am not vaccinated,” Zate said. “You’re long gone, at home unpacking your groceries, but because I walked through a place where you walked, I am now potentially infected.”
Early on, measles symptoms resemble a common cold or flu, but after four to five days patients experience high fever and a blotchy red rash appears, often spreading from the hairline down the entire body. While most people recover on their own in a few weeks, the disease kills one to three people out of every thousand, and one in five are hospitalized due to dehydration or serious complications like pneumonia and brain swelling, which are especially common among children under five. “There aren’t a lot of diseases that scare me, but this is on my short list,” Zate said. “Pediatricians have nightmares about this infection.”
When the first measles vaccine was licensed in 1963, many physicians hoped the measles would soon be a thing of the past. The incidence of the disease plummeted by 95% in five years, and in 2000 the World Health Organization declared measles effectively eliminated from the U.S. Today, however, that designation has come under threat amid growing vaccine skepticism, fueled by figures like Robert F. Kennedy Jr., the new U.S. secretary of Health and Human Services. On Wednesday, Kennedy said the measles outbreak near Lubbock was “not unusual,” a claim many medical professionals have disputed.
Although no cases have been reported in the tri-counties, Alpine ISD has been preparing for possible cases in the area. The school has communicated with parents about the risk of measles and shared guidance for checking vaccination records. “We’ve been following what’s happening, working with medical professionals to understand what we should watch for, how we would intervene, and what we do in the event of a local case,” Alpine ISD Superintendent Dr. Michelle Rinehart said. If there were cases in a school setting, unvaccinated children would be required by state law to stay home for at least 21 days.
If you or your child are unvaccinated and are exposed to the measles, you should seek medical care right away rather than wait for symptoms to develop, Zate emphasized. Even for those already infected, medical professionals can use vaccines to boost immunity and antibodies to fight off the disease. However, because measles is highly infectious, anyone with measles symptoms or exposure should call ahead so medical staff can take steps to minimize the risk of contagion.
Unvaccinated people can get the measles vaccine from their primary care provider or make an appointment at Department of State Health Services (DSHS) locations in Alpine, Marfa, Presidio, Van Horn, Andrews or El Paso — vaccines through DSHS are free for those without insurance. Though some children and older adults may not be vaccinated, anyone enrolled in U.S. public schools between 1965 and 2003 likely received the measles vaccine.
For healthy, vaccinated individuals, the risk of infection is extremely low. However, people with weakened immune systems — such as those undergoing chemotherapy or taking immunosuppressive medications for conditions like lupus — may still be at risk. If you’re unsure whether you or your child has been vaccinated, you can contact your primary care doctor, ask a school nurse, or complete a release form and email it to DSHS at ImmTrac2@dshs.texas.gov.