As measles cases in West Texas are still on the rise two months after the outbreak began, local public health officials say they expect the virus to keep spreading for at least several more months and that the official case number is likely an undercount.
But there's a silver lining, officials say: More people have received a measles, mumps and rubella vaccination this year in Texas and New Mexico, which also has an outbreak, compared to last year — even if it's not as high as they would like. And pharmacies across the U.S., especially in Texas, are seeing more demand for MMR shots.
As of Friday, the outbreak in Texas was up to 309 cases and one measles-related death, while New Mexico's case count was up to 42 and also one measles-related death. Forty-two people have been hospitalized across the two states.
Texas' outbreak, which has largely spread in undervaccinated Mennonite communities, could last a year based on studies of how measles previously spread in Amish communities in the U.S. Those studies showed outbreaks lasted six to seven months, said Katherine Wells, director of the public health department in Lubbock, Texas. Lubbock's hospitals have treated most of the outbreak's patients and the public health department is closely assisting with the response.
“It being so rural, now multistate, it's just going to take a lot more boots on the ground, a lot more work, to get things under control,” Wells said during a media briefing this week. “It's not an isolated population."
The outbreak includes 14 Texas counties, two New Mexico counties and four probable cases in Oklahoma, where health officials said the first two were “associated” with the West Texas and New Mexico outbreaks.
Measles is one of the world's most contagious diseases. The way it spreads makes it especially hard to contain and outbreaks can have multiple peaks, said Justin Lessler, an epidemiologist at the University of North Carolina’s Gillings School of Global Public Health.
Many people spread the measles virus unknowingly for days before the telltale rash appears. The virus also can hang in the air for up to two hours after a sick person has left a room.
“Within this community, it’d be perfectly reasonable to think probably another couple months before things die out,” Lessler said. “But if it gets into another community, you just potentially start that clock over again.”
If the outbreak goes on until next January, it would end the United States' status of having eliminated measles, which is defined as 12 months without local virus transmission, said Dr. William Moss, a pediatric infectious disease specialist at Johns Hopkins University and executive director of the International Vaccine Access Center.
“We’re only three months in. I think if we had a strong response where the messaging was clear that measles vaccination is the way to stop this outbreak, I would be surprised if it went for 12 months or more,” said Moss, who has worked on measles for 25 years, mostly in Africa. “But we’re not seeing that type of response, at least from the federal government.”
U.S. Health and Human Services Secretary Robert F. Kennedy Jr. instead has sown doubt about the measles vaccine, which has been safely used for more than 60 years and is 97% effective after two doses. In an interview with Fox News last week, Kennedy said MMR shots cause "deaths every year," although he later added that vaccinations should be encouraged.
Vaccinations are up in Texas and New Mexico
Still, there are signs the outbreak has had an effect on vaccinations, especially locally.
Between Feb. 1 and March 18 last year, New Mexico Department of Health registered 6,500 measles vaccines. During that timeframe this year, more than 11,600 measles vaccines were administered in New Mexico — about half given to adults and half to children.
Southeast New Mexico, where the outbreak is located, represents a large portion of the count, with 2,369 doses administered.
In Texas, at least 173,000 measles doses were given from Jan. 1 to March 16, compared to at least 158,000 over the same timeframe last year, according to the state health department. That includes more than 340 doses in given by public health in the West Texas outbreak area as of March 11.
Texans must opt-in to the state’s immunization registry, so most people’s vaccinations are not captured in the Texas Department of State Health Services numbers, department spokeswoman Lara Anton said.
“We don’t know if more people are opting in or if this is a true reflection of an increase in vaccinations," Anton wrote in an email. "It may be both.”
Pharmacy chains Walgreens and CVS told The Associated Press that they're seeing higher demand for MMR vaccines across the U.S., especially in the outbreak areas.
Texas health officials say they'd like to see more uptake in the communities at the epicenter of the outbreak, especially in Gaines County — where the childhood vaccination rate against measles is 82%. That's far below the 95% level needed to prevent community spread, and likely lower in the small religious schools and homeschooling groups where the early cases were identified.
Prasad Ganji is a pharmacist in Seminole, the biggest town in Gaines County. He said he ordered a 10-dose box of the MMR vaccine as cases started to spread.
He can give vaccines to people older than 14. But he still has doses left.
“The uptake for vaccines been definitely been a struggle," Wells said of Gaines County, "I want to be honest with that.”
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Credit: AP
Credit: AP