Texas measles outbreak grows to 90 cases, largest in over 30 years
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(AUSTIN, Texas) — The number of measles cases linked to an outbreak in western Texas has grown to 90, according to new data released on Friday.
Almost all of the cases are in unvaccinated individuals or individuals whose vaccination status is unknown, and 16 people have been hospitalized so far, according to the Texas Department of State Health Services. Five cases included those who have been vaccinated.
A DSHS spokesperson previously told ABC News that this marks the largest measles outbreak in the state in more than 30 years.
Children and teenagers between ages 5 and 17 make up the majority of cases with 51, followed by 26 cases among children ages 4 and under.
Gaines County is the epicenter of the outbreak, with 57 cases confirmed among residents, according to DSHS. State health data shows the number of vaccine exemptions in the county have grown dramatically.
Roughly 7.5% of kindergarteners had parents or guardians who filed for an exemption for at least one vaccine in 2013. Ten years later, that number rose to more than 17.5% — one of the highest in all of Texas, according to state health data.
Meanwhile, in neighboring New Mexico, at least nine cases have been confirmed in Lea County, which borders Texas, a spokesperson for the state Department of Health told ABC News on Friday.
Similarly to the local outbreaks, all of the nationally confirmed cases are in people who are unvaccinated or whose vaccination status is unknown.
Measles is one of the most contagious diseases known to humans. Just one infected patient can spread measles up to nine out of 10 susceptible close contacts, according to the CDC.
Health officials have been urging anyone who isn’t vaccinated to receive the measles, mumps, rubella (MMR) shot.
The CDC currently recommends people receive two vaccine doses, the first at ages 12 to 15 months and the second between 4 and 6 years old. One dose is 93% effective, and two doses are 97% effective.
(WASHINGTON) — Five years ago, the World Health Organization declared the COVID-19 outbreak to be a pandemic, leading to stay at-home orders and shutdowns across the U.S. and world.
The nation looks much different since then, and scientists and researchers have learned a lot about the virus, including how it infects people, the best forms of treatment and what puts someone at risk for long COVID.
There are still many questions, however. Health care professionals are working to find answers, such as how many people have truly died, how long the virus spread undetected in the U.S. and its origins.
“We know this emerged in China, around the city Wuhan. That’s very clear,” Dr. Cameron Wolfe, an infectious diseases specialist and a professor of medicine at Duke University School of Medicine, told ABC News. “We know when [the] medical community identified it, but we don’t know quite how long it was circulating before then. I think it’s caused some of the consternation.”
How many people have died of COVID-19?
As of March 6, at least 1,222,603 Americans have died of COVID-19, according to data from the Centers for Disease Control and Prevention.
The U.S. currently has the highest number of deaths of any country in the world, according to the WHO.
Experts, however, believe the true death toll is higher.
“More than a million people is a tragedy into itself, let’s start with that obvious fact,” Wolfe said. “I think the numbers are really hard to pin down for one key reason.”
Determining the exact cause of death can be complicated, Wolfe explained. Someone could die of COVID pneumonia — a lung infection caused by the virus — or die from a heart attack after contracting COVID.
Another example is an older adult who contracts COVID-19. They may become dehydrated, break a bone — because dehydration negatively impacts bone health — and suffer fatal complications, Wolfe said.
“How you count those outcomes is really important because, to me, that person wouldn’t have had their heart attack or that person wouldn’t have become dehydrated and fallen over and landed in the hospital if not for COVID triggering that event in the first place,” he said. “So, I actually think it’s really important to count those as COVID-associated mortalities, but they’re hard to count. They’re hard to track.”
Globally, more than 7 million people have died due to COVID-19, WHO data shows, although the agency says the pandemic caused an estimated 14.83 million excess deaths around the world in 2020 and 2021.
What is the mechanism behind long COVID
Scientists are not sure what causes long COVID but have identified certain risk factors such as an underlying health condition. Long-COVID symptoms can last for weeks, months or even years and can include — but are not limited to — fever, fatigue, coughing, chest pain, headaches, difficulty concentrating, sleep problems, stomach pain and joint or muscle pain, according to the CDC.
Research has found that patients with long COVID tend to have lower cortisol levels and lower testosterone levels.
“There are several questions that we still do not have answers for. What is the mechanism of the disease? Why do some people get more sick than others?” Dr. Fernando Carnavali, an internal medicine physician and a member of the team at Mount Sinai’s Center for Post-COVID Care, told ABC News.
Carnavali said scientists are using machine learning to study groups of long COVID patients in an attempt to determine the mechanisms that cause the condition.
“Do we have a single answer? Not as of yet, and most likely, perhaps we’ll have more than one answer,” he said.
Carnavali said the mechanism may not be the same for every long COVID patient. Additionally, people may have different symptoms due to different genetic predispositions.
“Some of the deficits that we have five years ago still remain, but I think that we should all understand and be hopeful that … researchers using machine learning will [provide] us some of the answers that we need as clinicians,” he said.
When did COVID enter the United States?
It’s still not exactly clear when the virus first entered the U.S. The first confirmed case in the country was Jan. 20, 2020, in a man in his 30s in Washington state, who developed symptoms after a trip to Wuhan.
However, studies have suggested the virus may have been circulating undetected for months beforehand.
Although the WHO was first notified on Dec. 31, 2019, about the mysterious pneumonia-like illness that originated in Wuhan, experts say it is likely that in an age of global travel, the virus was in the U.S. before then.
“It’s more likely circulated before Jan. 1 [2020]. It doesn’t seem unreasonable, November, December,” Dr. Lisa Olson-Gugerty, an associate teaching professor for Syracuse University and practicing family nurse practitioner in emergency medicine, told ABC News. “COVID masquerades itself as a flu-like illness, upper respiratory-like illness, like many other viral illnesses. It’s not easy to say, ‘Hey, I think this must be a new thing, and I’m going to tell everyone.'”
She went on, “I think it takes a bit of collective time to recognize a new viral strain, and it doesn’t seem unreasonable [there were] cases that could have been recognized as COVID before the date of release of information.”
Where did the virus come from?
There are two theories about where the virus, known as SARS-CoV-2, originated.
At least four U.S. agencies believe the virus was a result of natural transmission and that the virus jumped from animals to humans at a wet market.
The FBI, the CIA and the Department of Energy – the latter with “low confidence” — believe the COVID-19 pandemic “most likely” was the result of a laboratory leak in China.
Additionally, an April 2023 report from Senate Republicans conceded that “both hypotheses are plausible” but that the evidence points to the virus emerging from an accidental lab leak in Wuhan — and there may even have been multiple leaks.
If the virus did come from an animal, there are questions about which species may have spilled the virus over from animals to humans.
“I’ve seen a lot of conflicting information,” Olson-Gugerty said. “Did it come from a bat? Did it get into raccoon dogs or civet cats? Or was it a lab-created virus in Wuhan, China There does seem to be a jury that’s out.”
Wolfe said we may never know the true origins of SARS-CoV-2, but trying to answer the question helps scientists and public health professionals learn how to mitigate the spread so a pandemic — or even widespread illness — doesn’t happen again.
“This was the same question that happened during the Ebola pandemic, when we had to say, ‘Where did this come from? How can we educate people to minimize this future risk?'” he said. “It was important to examine where COVID-19 came from to try and put things in place that would stop that happening.”
He added, “We certainly, I would say, have better safety mechanisms now in place … so there are some good things that have come out of this.”
(SAN FRANCISCO) — A child in San Francisco was recently confirmed to be the third human case of bird flu in the United States in which it’s unclear how the person got infected.
Most human cases have occurred after coming into contact with infected cattle, infected poultry farms or other culling operations.
The CDC and other public health officials say there is currently no evidence of human-to-human transmission and the risk to the general public is low.
Doctors tell ABC News they agree but, with few cases that have an unknown — or unclear — source of infection, there may be evidence of some cases slipping through the cracks.
“There are reassuring factors here, which is the child appears to have had mild disease recovered…and kind of mild symptoms,” Dr. Tony Moody, a professor of pediatrics and infectious diseases specialist at Duke University, told ABC News.
Moody added, “That’s reassuring on the one hand, but it’s also concerning, because we don’t know, does this represent the only case, or is it one of 10,000 cases that just haven’t made their way into the health care system?”
Health officials in San Francisco first reported the bird flu case in the child earlier this month before it was confirmed by the CDC.
The child experienced symptoms of fever and eye irritation, and has since fully recovered, officials said. Investigators said they’re looking into how the child was exposed to the virus.
A CDC spokesperson confirmed this is the second child infected with bird flu in the country, the first case being in late November in California, also with unknown exposure.
The agency noted this is the third time that an exposure source has not been identified for a bird flu case with most other cases directly linked to exposure by infected livestock.
Moody said it’s hard what to make of the case because, while the CDC has bumped up surveillance, there are still gaps.
“It’s not universal surveillance. We’re not able to capture all of the cases that we might like to catch,” Moody said. “And so, it’s kind of hard to know what to do with isolated data points like this, when you get a report of, yes, this is a confirmed case. But it’s also like, what is the actual denominator here? How many cases are there really out there? And it’s kind of hard to tell.”
“So, I’m not sure that the identification of this case tells us a whole lot, other than, yep, it’s circulating,” Moody added.
Dr. Meghan Davis, an associate professor of environmental health and engineering at Johns Hopkins Bloomberg School of Public Health, told ABC News that because many of the cases have been mild, people with similarly mild symptoms may not be getting tested for bird flu.
For example, someone with pink eye, also known as conjunctivitis, may not associate it with bird flu, even with recent exposure to cattle.
“I’m certain that we’re missing some cases, because not everybody is going to even go to a health care provider if they’re sick and get swabbed,” she said. “There may be people who have more mild symptoms, and it doesn’t graduate to the level of ‘I need to go to urgent care’ or ‘I need to go to the hospital.'”
Both Moody and Davis said more surveillance needs to be conducted to catch cases that fly under the radar. Davis points out that the CDC is already doing this, announcing Thursday it is calling for a shortened timeline for subtyping all tests that are positive with influenza A to identify non-seasonal influenza.
The CDC said it is reminding clinicians and laboratories to test for influenza in patients with suspected cases and to expedite subtyping to determine if they have bird flu rather than seasonal flu.
“The reason this is important is that what you do for someone who has seasonal flu may be a little bit different than what you do when you’re dealing with a virus that’s novel and you don’t know entirely what to expect clinically, and you don’t know entirely what to expect in terms of its potential to continue to spread,” Davis said.
Moody added that it’s reassuring the recent pediatric case in California did not occur within a cluster of cases, such as an entire family becoming infected.
He explained it would be much more jarring to have a cluster of cases with unconfirmed infection compared to an isolated case.
“When we see a report of a cluster of cases, that’s when my blood pressure is going to go up,” Moody said. “Given everything else we know, I think let’s keep our worry proportional for now.”
ABC News’ Youri Benadjaoud contributed to this report.
(LUBBOCK, Texas) — An unvaccinated school-aged child in Texas has died of measles, the first associated with an outbreak in the western part of the state that has infected more than 100 people.
Lubbock city spokesperson Lauren Adams confirmed the death to ABC News on Wednesday.
In a press release, the Texas Department of State Health Services (DSHS) said the child was hospitalized in Lubbock, located in northwestern Texas, last week and tested positive for measles.
As of Wednesday, 124 cases of measles have been confirmed, according to data from DSHS.
Almost all of the cases are in unvaccinated individuals or individuals whose vaccination status is unknown, and 18 people have been hospitalized so far, DSHS said.
Children and teenagers between ages 5 and 17 make up the majority of cases with 62, followed by 39 cases among children ages 4 and under.
This is a developing story. Please check back for updates.