Texas measles outbreak surpasses 600 cases with most among children, teens

(NEW YORK) — Measles cases in the U.S. have surpassed 900 as outbreaks continue to spread across the county, according to new Centers for Disease Control and Prevention data published Friday.

A total of 935 cases have been confirmed in 29 states including Alaska, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, New Jersey, New Mexico, New York, Ohio, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Texas, Vermont, Virginia and Washington.

At least six states including Indiana, Kansas, Michigan, New Mexico, Ohio and Texas are reporting outbreaks, meaning three or more related cases.

The CDC says 13% of measles patients in the U.S. this year have been hospitalized, the majority of whom are under age 19.

Among the nationally confirmed cases, CDC says about 96% are among people who are unvaccinated or whose vaccination status is unknown.

Meanwhile, 2% are among those who have received just one dose of the measles, mumps, rubella (MMR) vaccine and 2% are among those who received the required two doses, according to the CDC.

Dr. Conrad Fischer, chief of infectious diseases at One Brooklyn Health in New York City, told ABC News he is concerned about the growing number of cases in the U.S.

“This is a disease that was at the level of complete eradication; this should not be happening,” he said. “It’s very sad to have an enormously safe vaccine that has been used in billions of people and to have a sort of cultural societal amnesia about what these illnesses were like in the past.”

In the decade before the measles vaccine became available, the CDC estimates that 3 to 4 million in the U.S. were sickened by measles every year, about 48,000 were hospitalized and about 400 to 500 people died. About 1,000 people suffered encephalitis, which is swelling of the brain.

Measles was declared eliminated from the U.S. in 2000 due to a highly effective vaccination program, according to the CDC. But vaccination rates have been lagging in recent years, leading to an increase in cases.

In Texas, where an outbreak has been spreading in the western part of the state, at least 663 cases have been confirmed as of Tuesday, according to the Texas Department of State Health Services.

Meanwhile, officials in Denton County — in the eastern part of the state outside Dallas and Fort Worth — reported its first measles case this week in a patient who attended a Texas Rangers game.

The infected individual, an adult with unknown vaccination status, visited Globe Life Field and a handful of restaurants and other locations, Denton officials said.

Additionally, Chicago reported its first measles cases this week, one in a suburban Cook County resident with unknown vaccination status and another in an adult Chicago resident who traveled internationally and received one dose of the MMR vaccine, according to the Chicago Department of Public Health and Cook County Department of Public Health.

It comes as a WHO report this week found that cases in the Americas are 11 times higher this year than they were at the same time last year.

Six countries, including the U.S., Canada, Mexico, Argentina, Belize and Brazil, have reported a total of 2,318 cases so far this year. Last year had 205 cases at the same time.

Fischer said measles is not a benign virus and can cause serious complications, especially among vulnerable individuals such as young children and immunocompromised people.

“Measles has a chance to literally destroy your brain, to cause pneumonia, ear infections and, although it is only fatal in a relatively small number of people, it spreads so amazingly easily that even if it’s only a few percentages, it’s something extremely dangerous,” he said.

Fischer emphasized that measles is the most contagious infectious disease known to humans, even compared to other dangerous diseases like tuberculosis.

“For instance, tuberculosis will spread only to two or 3% of the people exposed,” he said. “But if you are not vaccinated and you’re exposed to someone with measles, you have a 90% chance of getting that infection.”

Dr. Whitney Harrington, a physician in the division of infectious diseases at Seattle Children’s Hospital, told ABC News the U.S. is at risk of measles becoming endemic again unless vaccination rates increase.

The CDC currently recommends that people receive two doses of the MMR vaccine, 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 against measles, the CDC says.

“We really know that vaccines are the single most important public health intervention for preventing infectious disease,” Harrington said. “And we know that they’ve dramatically decreased really the number of cases and the severity of cases of many infections, including measles.”

She encouraged parents who have not vaccinated their children yet to speak with a doctor or a health care provider about vaccination and the benefits of vaccination.

ABC News Youri’ Benadjaoud contributed to this report.

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(LUBBOCK, Texas) — When the first measles cases were confirmed in western Texas, health officials said the infections primarily affected the Mennonite community.

Mennonites, who are part of the Anabaptist Christian church, have a small presence in the United States — and Texas in general — but they have a large presence in the South Plains region the state, and in Gaines County, which is the epicenter of the outbreak.

Many Mennonite communities are close-knit and under-vaccinated, which may have contributed to the spread of measles among members of the community.

But health officials are starting to see cases spread beyond the Mennonite population.

It is spreading beyond this community, “unfortunately,” Katherine Wells, director of public health for the city of Lubbock — which is located in western Texas — told ABC News. “West Texas is where the spread of these cases are right now, and we need to make sure that everybody in West Texas is getting vaccinated and is aware of measles and understands the precautions that we need to take.”

The outbreak in western Texas is continuing to grow with a total of 327 cases in at least 15 counties, according to new data published Tuesday.

Nearly all of the cases are in unvaccinated individuals or in individuals whose vaccination status is unknown, according to the Texas Department of State Health Services. At least 40 people have been hospitalized so far.

Just two cases have occurred in people fully vaccinated with the measles, mumps, rubella vaccine, according to the data.

Wells acknowledged that it may be easy for people to assume measles is only affecting a small and insular group like Mennonites and that nobody else is at risk.

“West Texas, you might say we’re small and insular compared to Dallas and some other areas,” she said. “But no, this has, unfortunately, moved into many, many different populations.”

“So unfortunately, it is growing and continues to grow,” she continued.

Marlen Ramirez, a community health worker and program coordinator at Vaccinate Your Family, which is an advocacy group based in Eagle Pass, Texas, shared a statement with ABC News, saying, “As a Community Health Worker living and working in a rural border town, I see firsthand how quickly diseases like measles can spread when vaccination rates are low and access to care is limited.”

“While the initial measles outbreak in western Texas affected members of the Mennonite community, the virus easily spreads wherever communities are under-vaccinated—and right now, we’re seeing cases reach into rural parts of Texas, New Mexico, and Kansas,” Ramirez added.

“In many of these areas, vaccination rates are below 90%, well below the 92-94% needed for community or “herd” immunity. That’s what has allowed this outbreak to grow to over 300 cases so quickly. We fear the number of actual cases may be much higher than reported due to confusion and delays in the outbreak response,” she said.

A spokesperson for DSHS confirmed to ABC News that the first cases in the outbreak were among Mennonite community members, but this is no longer the case.

“Since 90% of unvaccinated people exposed to the measles virus will become ill, there are many cases in people who are not part of the Mennonite community,” the spokesperson said. “We do not ask a person’s religious affiliation as part of our case investigation process, so we have no way of counting how many cases are part of the Mennonite community and how many are not.”

Why the Mennonite population was hit hard by measles cases
Steven Nolt, professor of history and Anabaptist studies at Elizabethtown College in Pennsylvania, told ABC News that culturally conservative and Old Order Mennonites have traditionally been under-immunized or partially immunized.

He said there are no religious teachings or bodies of religious writings that prevent Mennonites from being vaccinated. The DSHS spokesperson also added that that Mennonite religion is not “widely against vaccination.”

“Reasons are not religious but reflect everything from less frequent engagement with health care systems (for those who are more rural) to a traditional outlook that replicates practices of parents and grandparents more than the most current practices,” Nolt said via email.

For example, culturally traditional Mennonites may have participated in mid-20th century vaccination campaigns against diseases like smallpox, leading to their children and grandchildren trusting those vaccines compared to more recent additions to the immunization schedule, Nott said.

He added that Mennonites may also be influenced by the opinions of their neighbors, which may play a role in lack of vaccination.

Nolt also explained that the Mennonites who live in Seminole, Texas, a city at the center of Gaines County — a community known as Low German Mennonites, due to the language they speak — “lived in relative isolation in Mexico from the 1920s to the 1980s.”

“They missed out on the mid-century public health immunization campaigns in the U.S., be they polio or smallpox or whatever (the Mexican government had a reputation for not engaging with the Low German Mennonites at all),” he wrote. “Thus, they are starting from a different place than other culturally conservative Mennonites whose ancestors have been here since the 1700s.”

Nott went on, “My point is, the so-called Low German Mennonites from Mexico, now in west Texas, don’t have that minimum baseline of mid-20th century vaccine acceptance that we see among Old Order Mennonites and Amish in the U.S. because the folks in Seminole missed the whole mid-century immunization push, as they weren’t in the U.S. at that time.”

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(LUBBOCK, TEXAS) — A second child in Texas has died of measles, according to the Texas Department of State Health Services.

“The school-aged child who tested positive for measles was hospitalized in Lubbock and passed away on Thursday from what the child’s doctors described as measles pulmonary failure,” the statement said, in part. “The child was not vaccinated and had no reported underlying conditions.”

The University Medical Center in Lubbock, Texas, said the child had been receiving care for “complications of measles while hospitalized” and also emphasized, as the state health department did, that the child was unvaccinated with no underlying conditions.

An unvaccinated school-aged child also died of measles in Texas in late February, according to the Texas Department of Health Services – the first measles death in a decade in the United States. A week later, an unvaccinated adult in New Mexico died with measles, the New Mexico Department of Health reported.

The outbreak has so far led to 642 confirmed cases across 22 states, but the vast majority — 499 cases — have been in Texas, Health and Human Services Secretary Robert F. Kennedy posted on X on Sunday afternoon.

Kennedy also said in the post that he visited Texas on Sunday to “comfort” the family of the child. He said he’d developed a close relationship with the impacted community — which has largely been unvaccinated — including the family of the first child to die in the outbreak.

He added that the “most effective way to prevent the spread of measles” is the measles, mumps and rubella — or MMR — vaccine.

The HHS secretary, who has a long history of vaccine skepticism, has come under fire from public health officials for downplaying the measles outbreak and not advocating enough for widespread vaccination.

In Kennedy’s first public comments on the measles outbreak last month, he said that outbreaks were not “uncommon” because they happen every year and declined to specifically encourage vaccination.

Public health experts who criticized Kennedy pointed out that outbreaks do not have to happen every year and are preventable with the MMR vaccine, which is 97% effective with two doses. Kennedy has since repeated that the vaccine is the “most effective way” to prevent measles, though often also noted that it’s a “personal choice.”

Republican Sen. Bill Cassidy, a physician who publicly wrestled with his support for Kennedy but eventually voted to support him as HHS secretary, said the second death in Texas proved that “top health officials” should be “unequivocally” encouraging the vaccine.

“Everyone should be vaccinated!” Cassidy wrote on X Sunday. “There is no treatment for measles. No benefit to getting measles. Top health officials should say so unequivocally [before] another child dies.”

The Texas Department of State Health Services said on April 4 that Texas is experiencing its worst measles outbreak in 30 years.

There are more than double the number of cases of measles in the U.S. in the first quarter of this year than the entirety of last year, which saw 285 cases nationwide, according to the Centers for Disease Control and Prevention.

These are the highest number of measles cases in the U.S. since 2019, which saw 1,274 cases, according to the CDC. New Mexico is experiencing its worst measles outbreak in 40 years, with 54 cases. Kansas and Ohio are also experiencing outbreaks.

If the number of this year’s cases continues to grow at the current rate, the U.S. would likely surpass that 2019 number, which would lead to the highest number of cases in the U.S. since 1992.

The U.S. declared measles eliminated in the year 2000, after finding no continuous spread of the highly contagious disease over 12 months. The country would be at risk of losing that status if an outbreak continued for more than one year. The Texas outbreak saw its first measles cases in January.

The CDC currently recommends that people receive two doses of the MMR vaccine, 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 against measles.

In his statement on Sunday, Kennedy said a CDC team was deployed to Texas in early March to support state and local health officials and to supply pharmacies and clinics with MMR vaccines.

“I’ve spoken to Governor Abbott, and I’ve offered HHS’ continued support. At his request, we have redeployed CDC teams to Texas. We will continue to follow Texas’ lead and to offer similar resources to other affected jurisdictions,” he said in the post.

Kennedy’ visit to Texas comes shortly after the secretary, a prominent vaccine skeptic, has cut one-fourth of the HHS workforce and one-fifth of those employed by the CDC.

The HHS recently clawed back roughly $11 billion in funding from state and local health departments for COVID recovery efforts, saying the money was no longer needed as the pandemic was over. But health officials said the money was being used to better equip communities’ abilities to deal with the spread of diseases — including measles — and better prepare for the next pandemic.

Dr. Philip Huang, the top health official for the city of Dallas, told ABC News that the cuts to the HHS funding and its workforce could impact efforts to respond to the measles outbreak in his state.

“This definitely impacts our measles response,” he said. “We were looking to build out our lab capacity, some of our ability to get immunizations out into the community and into schools.”

“These smaller health departments, they don’t have many staff. You make a small cut and that takes away a considerable percentage of their workforce and ability to respond to anything at all,” Huang said.

ABC News’ Benjamin Siegel contributed to this report.

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