In January 2025, an outbreak of measles began spreading in Texas and later in February in New Mexico. The cause of the outbreak was attributed to declining vaccination rates among infants.
Background

In the United States, before the measles vaccination program started in 1963, the Centers for Disease Control and Prevention (CDC) estimated that about three to four million people were infected each year, of which approximately 500,000 were reported, with 400 to 500 people dying and 48,000 being hospitalized.[2] Measles is one of the most contagious viruses, and can be passed through respiratory droplets in the air, with unvaccinated individuals at 90% risk of getting measles if they are exposed.[3] Symptoms usually develop 10–12 days after exposure to an infected person and last 7–10 days.[4][5] Initial symptoms typically include fever, often greater than 40 °C (104 °F), cough, runny nose, and inflamed eyes, with a red, flat rash which usually starts on the face and then spreads to the rest of the body.[6][7][6]

The MMR vaccine is a safe and effective preventative measure against measles with the first dose given to children between 12 and 15 months of age and a second dose between 4 and 6 years.[8] Though measles was eliminated in the United States in 2000, falling vaccination rates have contributed to its resurgence.[8] Vaccination rates among children have dropped since the COVID-19 pandemic and most states are now below the 95% threshold considered effective to prevent community outbreaks.[8][9]
The high rate of vaccination exemptions in Gaines County, Texas, has been blamed for the outbreak.[10] It has one of the highest rates in the country of vaccine opt-outs among children, with nearly 14% skipping a required vaccine in the prior school year.[11] The outbreak has been concentrated in a Mennonite community known to be under-vaccinated.[8]
Epidemiology
As of March 7, 2025, 228 cases have been confirmed.[1] In mid February it was reported that of the reported cases 39 were aged between 0–4 years old, 62 were aged 5–17 years old, 18 were aged 18 and older, with five cases not completely age identified.[3]
Texas
On January 17, 2025, the Houston Health Department confirmed two cases of measles, the first reported cases in Houston since 2018. The patients were in the same household and had traveled recently.[12] Two cases in unvaccinated school-age children in Lubbock, Texas, were later confirmed; the last case of measles in Lubbock County was reported in 2004.[13] The first child in Lubbock had contracted the disease after sitting in an emergency room with another child who was sick.[8] The children resided in Gaines County.[14] By February 7, the number of confirmed cases had increased to nine with three probable cases,[15] before reaching fourteen confirmed cases with six probable cases.[16]
By mid February it was reported that the outbreak had spread to nine Texas counties mostly concentrated in the rural South Plains region, with counties including Dallam, Dawson, Ector, Gaines, Lubbock, Lynn, Terry, and Yoakum.[3] It was reported on February 24, that a person with measles had traveled outside of the outbreak area, to visit the campus of University of Texas at San Antonio and other local establishments.[17]
By late February more than 20 patients have been hospitalized at Covenant Children's Hospital with some suffering bacterial pneumonia and requiring intubation to breathe.[8] On February 26, an unvaccinated school-age child died of measles in Lubbock, the first death attributed to the outbreak.[18] It was the first measles death in the country since 2015.[19]
Legacy Traditional School, a charter school in Cibolo, near San Antonio, told parents on February 27 that a student was infected with measles.[20] However, the child was actually infected with rubella, a different disease that can also be prevented by the same MMR vaccine.[21]
Austin confirmed on February 28 its first measles case since 2019, an unvaccinated infant who contracted the disease while overseas.[22]
New Mexico
On February 3, New Mexico health officials began checking residents for measles.[23]
On March 6, an unvaccinated adult in Lea County died and was later revealed to have contracted measles prior to his death.[24]
Responses
During a cabinet meeting on February 26, Robert F. Kennedy Jr., the United States secretary of health and human services, stated: "We are following the measles epidemic every day. Incidentally, there have been four measles outbreaks this year. In this country last year there were 16. So, it's not unusual. We have measles outbreaks every year."[25] Kennedy, who is known for his anti-vaccine activism and history of downplaying measles resurgences, also stated incorrectly that there were two deaths and that the hospitalizations were for quarantine purposes.[18][26] Only one death has been recorded,[19] and officials in Lubbock stated that they do not hospitalize patients for quarantine purposes and that the children who were admitted were having difficulty breathing (with some requiring intensive care and supplemental oxygen). They added that all of the admitted children were unvaccinated.[25] On March 2, Kennedy published an opinion piece about the outbreak on Fox News.[27] He suggested parents consult with healthcare providers about vaccination, but did not explicitly recommend it, stating the choice was "personal."[28][29]
Infectious disease experts including Cameron Wolfe of Duke University, David Higgins of the University of Colorado, and former head of the National Immunization Program Walter Orenstein objected to the description of the outbreak as "not unusual" and stated the child's death was fully preventable with proper vaccination.[18][19] Ali S. Khan, the former Director of the Office of Public Health Preparedness and Response at the Centers for Disease Control and Prevention (CDC) called for political officials at all levels to promote vaccination.[30] In contrast to the 2019 New York measles outbreak—when CDC officials and Health Secretary Alex Azar urged vaccination—the CDC and Health Secretary have not released statements or made posts on social media urging vaccination.[31] Senator Bill Cassidy, who chairs the Senate health committee, tweeted that the death was "absolutely devastating" and encouraged parents to vaccinate their children.[31][32]
Schools have not ordered unvaccinated students to stay home as this would require declaring a state of emergency.[33] The Texas Department of State Health Services stated that such a declaration was not necessary since 90% of Texans are vaccinated; they ordered a 21-day quarantine for exposed unvaccinated individuals, but this would not be tracked or enforced.[33]
As news of the outbreak spread, health officials reported a rise in families deciding to vaccinate their children. The director of public health in Lubbock county stated that in the last week of February 2025 they had given approximately 100 doses of the MMR vaccine to children who had previously been unvaccinated or whose parents did not believe in vaccines.[34] Vaccine-hesitant parents, including those who had sought exemptions for their children, were also bringing them to receive vaccines.[35]
See also
- 2019 Samoa measles outbreak
- Measles resurgence in the United States
- MMR vaccine
- Vaccine hesitancy
- History of public health in the United States
Notes
References
- ^ a b c Mukherjee, Neha (March 7, 2025). "Nearly 230 measles cases reported in outbreaks in West Texas and New Mexico". CNN. Retrieved March 7, 2025.
- ^ "Measles Frequently Asked Questions about Measles in U.S". U.S. Centers for Disease Control and Prevention (CDC). August 28, 2018.
- ^ a b c Simpson, Stephen; Langford, Terri; Klibanoff, Eleanor (2025-02-19). "West Texas measles cases rise to 124. Here is what you need to know". The Texas Tribune. Retrieved 2025-02-27.
- ^ "Measles Fact sheet N°286". World Health Organization. November 2014. Archived from the original on 3 February 2015. Retrieved 4 February 2015.
- ^ Bope, Edward T.; Kellerman, Rick D. (2014). Conn's Current Therapy 2015. Elsevier Health Sciences. p. 153. ISBN 978-0-323-31956-0. Archived from the original on 2017-09-08.
- ^ a b "Measles (Rubeola) Signs and Symptoms". Centers for Disease Control and Prevention. 3 November 2014. Archived from the original on 2 February 2015. Retrieved 5 February 2015.
- ^ Caserta, MT, ed. (September 2013). "Measles". Merck Manual Professional. Merck Sharp & Dohme Corp. Archived from the original on 23 March 2014. Retrieved 23 March 2014.
- ^ a b c d e f Shastri, Devi; Seitz, Amanda (2025-02-26). "A Texas child who was not vaccinated has died of measles, a first for the US in a decade". AP News. Retrieved 2025-02-27.
- ^ Stobbe, Mike (2024-10-02). "US school-entry vaccination rates fall as exemptions keep rising". AP News. Retrieved 2025-02-27.
- ^ Moniuszko, Sara; Higgins, David (February 12, 2025). "Measles outbreak in Texas was "completely preventable," infectious disease expert says". CBS News. Retrieved February 26, 2025.
- ^ Smith, Peter (2025-02-26). "Who are the Mennonites in a Texas community where measles is spreading?". AP News. Retrieved 2025-02-27.
- ^ Zuvanich, Adam (January 17, 2025). "Houston Health Department reports city's first measles cases in seven years". KUHF. Retrieved February 26, 2025.
- ^ Simpson, Stephen; Carter, Jayme (January 30, 2025). "Measles cases reported in Texas as vaccine rate against the disease has fallen". The Texas Tribune. Retrieved February 26, 2025.
- ^ Brindley, Emily (January 30, 2025). "Texas officials identify 2 measles cases in unvaccinated school-age children". The Dallas Morning News. Retrieved February 26, 2025.
- ^ Mole, Beth (February 7, 2025). "Measles outbreak erupts in one of Texas' least-vaccinated counties". Ars Technica. Retrieved February 26, 2025.
- ^ McPhillips, Deidre (February 7, 2025). "Measles outbreak expands in West Texas around county with low vaccination rate". CNN. Retrieved February 26, 2025.
- ^ Edwards, Erika (2025-02-26). "As Texas measles outbreak grows, parents are choosing to vaccinate kids". www.aol.com. Retrieved 2025-02-27.
- ^ a b c Levenson, Michael; Rosenbluth, Teddy; Mandavilli, Apoorva (February 26, 2025). "Unvaccinated Child Dies of Measles in Texas, Officials Say". The New York Times. Retrieved February 26, 2025.
- ^ a b c Branswell, Helen (2025-02-26). "Texas measles outbreak marks first fatality as more cases reported". STAT. Retrieved 2025-02-27.
- ^ Whitney, Luke; Lynch, David (February 27, 2025). "DSHS says no confirmed measles case in San Antonio area school, despite Legacy Traditional School's notice: The Cibolo school told KENS 5 earlier in the afternoon there was a "confirmation of a measles case." The state says they haven't heard that". KENS channel 5 TV. Retrieved February 28, 2025.
- ^ Phillips, Camille (February 27, 2025). "San Antonio-area charter school now says they have a case of rubella, not measles". Texas Public Radio. Retrieved February 28, 2025.
- ^ Shastri, Devi; Press, Associated (2025-03-01). "Texas measles outbreak rises to 146 cases spanning more than 9 counties". PBS News. Retrieved 2025-03-02.
- ^ Prokop, Danielle (February 3, 2025). "Texas measles outbreak puts New Mexico health officials on alert". Source NM. Retrieved February 26, 2025.
- ^ Shastri, Devi (March 6, 2025). "New Mexico adult dies with measles, though cause of death isn't yet confirmed". Retrieved March 6, 2025.
- ^ a b Edwards, Erika (February 26, 2025). "First measles death reported in Texas as Kennedy downplays the outbreak". NBC News. Retrieved February 26, 2025.
- ^ Dervisevic, Hanan (2025-02-27). "RFK Jr says US measles outbreak is 'not unusual' after first death in a decade". ABC News. Retrieved 2025-02-27.
- ^ Kennedy, Robert (2025-03-02). "ROBERT F. KENNEDY JR.: Measles outbreak is call to action for all of us". Fox News. Retrieved 2025-03-03.
- ^ Kounang, Nadia (2025-03-03). "As measles outbreak grows, HHS secretary says vaccination is a personal decision that can protect individuals and communities". CNN. Retrieved 2025-03-03.
- ^ Rosenbluth, Teddy (2025-03-02). "Federal Officials Underplaying Measles Vaccination, Experts Say". The New York Times. Retrieved 2025-03-03.
- ^ Julie Steenhuysen, Chad Terhune (2025-02-27). "Measles death in Texas puts Kennedy's vaccine views to the test". Reuters. Retrieved 2025-02-27.
- ^ a b Joseph, Andrew (2025-02-27). "On measles outbreak, the Trump administration's messaging strikes some as off-key". STAT. Retrieved 2025-02-28.
- ^ @SenBillCassidy (February 26, 2025). "Absolutely devastating news. Encouraging parents to make sure their child is up-to-date on their vaccines. The measles vaccine is safe and effective" (Tweet) – via Twitter.
- ^ a b Klibanoff, Eleanor; Salhotra, Pooja; Langford, Terri; Carver, Jayme Lozano (2025-02-28). "Texas leaders quiet amid the biggest measles outbreak in decades". The Texas Tribune. Retrieved 2025-02-28.
- ^ "As Texas measles outbreak grows, parents are choosing to vaccinate kids". NBC News. 2025-02-25. Retrieved 2025-03-02.
- ^ Mole, Beth; Technica, Ars (2025-03-01). "Texas Official Warns Against 'Measles Parties' Amid Growing Outbreak". WIRED. Retrieved 2025-03-02.
External links
- Malenfant, Marley (February 11, 2025). "Measles outbreak in Texas affecting children. Here are symptoms parents should watch for". Austin American-Statesman. Retrieved February 26, 2025.
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