Texas’ measles outbreak is nation’s largest since 2000

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The measles outbreak that originated in Texas is now the largest single outbreak since the United States declared the disease eliminated in 2000, according to the Centers for Disease Control and Prevention.

A CDC spokesperson told The Texas Tribune they view the spread of measles in Texas, Oklahoma, and New Mexico as a single outbreak. With over 750 confirmed cases, it surpassed the New York City outbreak in 2019, which had 697 cases.

Texas has the vast majority of measles cases, with more than 700 cases reported since January, as of Tuesday. Of those, over 90 patients have been hospitalized, and two school-aged children have died, the first measles deaths in a decade in the country.

Typically, measles outbreaks slow down during summer months when children are no longer in school and infecting each other. But, if numbers continue to grow like they have been by summer’s end, Texas could continue to break records, said Sahotra Sarkar, an integrative biology professor at the University of Texas at Austin.

“If the number of cases keeps on increasing for the rest of the year, as it has been for the last few months, then this will be the biggest outbreak since about the late 1990s, before measles was declared eliminated. We are going to be in bad shape in this entire southwestern area,” said Sarkar, who studies disease ecology and epidemiology.

Public health officials have emphasized that the most effective way to prevent measles is to obtain two doses of the measles-mumps-rubella shot. But, anti-vaccine sentiment has pushed pockets of Texas to fall below the 95% vaccination rate needed for herd immunity against measles.

“Sooner or later, you hit that critical threshold where a sufficient number of people are vaccinated that it can’t spread any further. If we go by the past, it will decrease then,” he said.

The New York Times first reported that the measles outbreak was the largest since 2000 after obtaining a recording of a video call in which federal scientists told various state officials about the current situation.

The southwest measles outbreak has followed the same path as the previous largest outbreak.

The 2019 measles outbreak in New York City spread quickly among the mostly Orthodox Jewish community, which had a low vaccination rate at the time. The current outbreak, which originated in Texas, spread across Mennonite communities, which often have low vaccination rates and have been disproportionately affected.

However, Sarkar said the southwest measles outbreak is more localized than what happened in New York, making it harder to track where the next hot spot might occur.

“In 2019, many infection rates were brought from Ukraine and Israel, and due to the plane connectivity, you could see where the hotspots would be. You multiply travel volume by lack of vaccination rates, and you get a fairly good picture of what happened. But here we are seeing a spread due to local travel and low vaccination rates,” he said.

Local travel is unpredictable, and with various parts of the state having low herd immunity, the next hotspot can be anywhere, Sarkar said.

History can only teach us so much about how to deal with this outbreak, Sarkar said, and vaccinating more people will help stop the outbreak.

“I have nothing particularly new to say compared to what we said in 2019, which is that the easiest and most effective way of preventing outbreaks is to vaccinate the unvaccinated children as fast as possible, even a single dose of the vaccine can make a huge difference,” he said.

Disclosure: New York Times and University of Texas at Austin have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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