Texas measles outbreak spills into third state as cases reach 258

Two people in Oklahoma have likely contracted measles infections linked to a mushrooming outbreak that began in West Texas, which has now risen to at least 258 cases since late January.

On Tuesday, Oklahoma's health department reported that two people had "exposure associated with the Texas and New Mexico outbreak" and then reported symptoms consistent with measles. They're currently being reported as probable cases because testing hasn't confirmed the infections.

There was no information about the ages, vaccination status, or location of the two cases. The health department said that the people stayed home in quarantine after realizing they had been exposed. In response to local media, a health department spokesperson said it was withholding further information because "these cases don’t pose a public health risk and to protect patient privacy."

In the latest data, only 88 percent of Oklahoma's kindergartners were up to date on measles vaccination, significantly below the 95 percent target to prevent community spread.

The state health department did not immediately respond to a request for more information from Ars Technica.

In a press announcement, Kendra Dougherty, director of Infectious Disease Prevention and Response for Oklahoma's health department, said: "These cases highlight the importance of being aware of measles activity as people travel or host visitors. When people know they have exposure risk and do not have immunity to measles, they can exclude themselves from public settings for the recommended duration to eliminate the risk of transmission in their community." The recommended quarantine period is 21 days to see if symptoms develop.

Measles is one of the most infectious diseases on the planet, infecting 90 percent of unvaccinated people exposed. People are considered contagious starting four days before the telltale rash develops to four days after it appears. Potential serious complications from measles can include pneumonia, brain inflammation, compromised immune responses to secondary infections (immune amnesia), a fatal degenerative disease called subacute sclerosing panencephalitis, and death.

Texas and New Mexico

Meanwhile, the Texas health department on Tuesday provided an outbreak update, raising the case count to 223, up 25 from the 198 Texas cases reported Friday. Of the Texas cases, 29 have been hospitalized and one has died—a 6-year-old girl from Gaines County, the outbreak's epicenter. The girl was unvaccinated and had no known underlying health conditions.

The outbreak continues to be primarily in unvaccinated children. Of the 223 cases, 76 are in ages 0 to 4, and 98 are between ages 5 and 17. Of the cases, 80 are unvaccinated, 138 lack vaccination status, and five are known to have received at least one dose of the Measles, Mumps, and Rubella vaccine.

One dose of MMR is estimated to be 93 percent effective against measles, and two doses offer 98 percent protection. It's not unexpected to see a small number of breakthrough cases in large, localized outbreaks.

Across the border from Gaines County in Texas sits Lea County, where New Mexico officials have now documented 32 cases, with an additional case reported in neighboring Eddy County, bringing the state's current total to 33. Of those cases, one person has been hospitalized and one person (not hospitalized) died. The death was an adult who did not seek medical care and tested positive for measles only after death. The cause of their death is under investigation.

Of New Mexico's 33 cases, 27 were unvaccinated and five did not have a vaccination status, and one had received at least one MMR dose. Eighteen of the 33 cases are in adults, 13 are ages 0 to 17, and two cases have no confirmed age.

On Friday, the Centers for Disease Control and Prevention released a travel alert over the measles outbreak. "With spring and summer travel season approaching in the United States, CDC emphasizes the important role that clinicians and public health officials play in preventing the spread of measles," the agency said in the alert. It advised clinicians to be vigilant in identifying potential measles cases.

The agency stressed the importance of vaccination, putting in bold: "Measles-mumps-rubella (MMR) vaccination remains the most important tool for preventing measles," while saying that "all US residents should be up to date on their MMR vaccinations."

US health secretary and long-time anti-vaccine advocate Robert F. Kennedy Jr, meanwhile, has been emphasizing cod liver oil, which does not prevent measles, and falsely blaming the outbreak on poor nutrition.

Texas and New Mexico

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