Measles has continued to spread in Texas, with the first known death of the outbreak – an unvaccinated school-age child – confirmed by state health officials on Wednesday.
As of Tuesday, 124 cases had been reported since late January, primarily in the South Plains region. Eighteen of the patients have been hospitalized; five of the cases are vaccinated, and the rest are unvaccinated or their vaccination status is unknown.
The Texas Department of State Health Services is working with local health departments to investigate the outbreak.
Dr. Jennifer Shuford, the department’s commissioner, said there was also exposure from an infected person in San Antonio and other parts of the Hill Country over Valentine’s Day weekend.
“The incubation period for measles can stretch for 21 days,” she said. “And so we still have a while to wait after that initial exposure to see if any of those individuals turn positive or get infected with measles. The usual incubation period is about 10 to 12 days. So that’s when we would expect to start identifying any cases that were spread during that travel to Central Texas.”
Shuford said the test for measles is accurate, but it is possible that not everyone who has symptoms of the illness will go to the doctor to get tested.
“People will frequently first start getting a fever, and then they’ll get things like watery eyes and runny nose and a cough, and then they’ll start getting the rash,” she said. “And the rash starts usually up on the head and on the scalp, near the hairline, and then goes down the body.
“While that rash is beginning, that fever can be really high. We see fevers of like 103, 104 and 105 with measles. And so we expect that fever and that rash along with some other respiratory symptoms. And then the rash and the fever will start to go away as that person becomes less infectious.”
Shuford said people stop being infectious about four days after that rash starts, which marks when those who have been infected can exit quarantine. The best way to protect yourself from infection is to get vaccinated, she said.
“That vaccine is highly effective and was the reason why measles was eliminated from the United States in the year 2000,” Shuford said. “We know that that vaccine works, and that’s the best protection that we can get to communities at any time of a person’s lifetime, but especially during an outbreak.”
Shuford said the vaccine is effective for life, so people who have documentation that they were vaccinated as a child do not need to worry about a booster. However, she said if someone is unsure of their vaccination status, it is best to get it just in case.
» MORE: Boosters, symptoms, herd immunity: Everything to know about the measles outbreak in Texas
Amid rising anti-vaccination sentiment in the United States, Shuford also addressed concerns about vaccine safety.
“We know that the benefits of this vaccine outweigh the risks,” she said. “We are seeing the risks of actually getting the infection right now with the people who are getting measles infection, are going to the hospital and having complications from measles.
“We know that a certain number of people during a large outbreak can die. And so when we measure the vaccine against those risks, yes, the benefits of the vaccine outweigh the risks.”
With measles, Shuford said asymptomatic patients are not a concern. Unlike COVID-19, measles is unlikely to be spread by people who carry the disease but are not showing symptoms.
Measles also isn’t particularly deadly, Shuford said, but some people could face more serious illness.
“We actually expect 5% of people to get pneumonia and up to 20% to end up in the hospital. So there are a lot of complications that can happen for measles,” she said. “There are certain people who are more vulnerable. We know that kids under the age of 1, so infants, are particularly vulnerable, as are pregnant women and other immunocompromised adults.”
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Texas’ caseload for measles is increasing quickly, Shuford said.
“Our cases that we are recording are increasing faster than a lot of other outbreaks that are happening right now or have happened, say, in the last 10 years,” she said. “We’re worried about the pace of this outbreak and how many people could potentially be infected before we have it contained or under control.”
Shuford said it is still considered safe to travel to regions in Texas with measles outbreaks, as long as travelers are vaccinated with the full two doses of the MMR vaccine. However, if someone isn’t vaccinated or has a child too young to be vaccinated, Shuford recommended avoiding areas with a high number of cases.
As for the timeline of the outbreak, Shuford said that depends on a number of factors.
“It depends on how many people are vaccinated in these regions where measles is traveling,” she said. “What we’ve seen from previous outbreaks is that they usually last somewhere between two and six months, and it could be longer than that.
“That is what we are preparing for is a timeline that looks something like that. We’re hoping to contain it faster, especially if we can get word out about the effectiveness of the vaccines and the availability of them in this outbreak area.”
