Measles outbreak in Texas finally disclosed due to low vaccination rates but numbers of infected are likely higher than reported

Measles outbreak erupts in one of Texas’ least vaccinated counties
Echo report published in ARS Technica by Beth Mole (Texas).

9 cases are confirmed and 3 are probable. Officials says more are very likely to come.

Health officials in Texas are battling a growing measles outbreak in an area that has some of the state's lowest vaccination rates and highest non-medical exemptions.

On January 30, officials reported two measles cases in unvaccinated, school-aged children in Gaines County, which sits at the border of New Mexico and is around 90 miles southwest of Lubbock, Texas. Both children were hospitalized in Lubbock and had been discharged.

As of mid-day February 7, the outbreak total reached nine confirmed measles cases in the South Plains Public Health District (SPPHD) that includes Gaines, according to Zach Holbrooks, Executive Director for SSPHD. In an interview with Ars, Holbrooks reported that there were three additional probable cases that are linked to the confirmed cases. These are cases in the same household or family—maybe a cousin or sibling—that are showing measles symptoms but haven't been tested yet or gotten their test results back yet, Holbrooks said. So far, there have been no other reports of hospitalizations besides those in the first two cases (that we know of.....❓).

Holbrooks said he expected the number of confirmed cases to rise by the end of the day or tomorrow morning.
Vulnerable community

Gaines County has one of the lowest vaccination rates in the state of Texas and has among the highest rates of children with "conscientious exemptions" to school vaccination requirements.

According to state data for the 2023–2024, school year, only about 82 percent of kindergarteners in public schools in Gaines County were up to date on their vaccinations, including doses of Measles, Mumps, and Rubella (MMR) vaccine. The public health target for vaccination coverage is 95 percent, which is the level that can prevent community spread of vaccine-preventable diseases and shield vulnerable members, including children too young to vaccinate and people with compromised immune systems.

With 82 percent vaccinated, Gaines County ranks in the bottom ten counties with the lowest coverage among those reporting data (four counties out of over 250 did not report). Nearly 18 percent of kindergarteners in Gaines have conscientious exemptions, which is an exemption from school vaccination requirements based on reasons of conscience, including a religious belief.

Still, the county-wide number obscures pockets of yet lower vaccination rates. That includes the independent public school district in Loop, in the northeast corner of Gaines, which had a vaccination rate of 46 percent in the 2023–2024 school year❗

Holbrooks noted that the county has a large religious community with private religious schools. These may have yet lower vaccination rates. Holbrooks said that, so far, the measles cases being seen and traced in the outbreak are linked to those private schools.
Public health response

To try to prevent disease transmission, Holbrooks and other state and local officials are getting the word out about the outbreak and running vaccination clinics. About 30 children were vaccinated in a mobile vaccination drive yesterday, he reported.

"We're trying to get out the message about how important vaccination is," he said.

He's also emphasizing that, while children with measles symptoms—very high fever, cough, runny nose, red/watery eyes, and of course, the tell-tale rash—should see a health care provider, parents need to call the office in advance so a child potentially infected with measles doesn't end up sitting in a waiting room among other potentially vulnerable children.

"Measles is highly communicable," he notes. The viral illness is one of the most highly infectious diseases on the planet, and about 90 percent of unvaccinated people who are exposed to it will end up falling ill. The virus spreads through the air and can linger in the airspace of a room for up to two hours after an infected person has left.

In addition to a generally miserable illness, measles can cause complications: 1 in 5 unvaccinated people with measles in the US end up hospitalized. About 1 in 10 develop ear infections and/or diarrhea, and 1 in 20 develop pneumonia. Between 1 to 3 in 1,000 die of the infection. In rare cases, it can cause a fatal disease of the central nervous system called Subacute sclerosing panencephalitis, which typically develops 7 to 10 years after an infection. Measles can also devastate immune responses to other infections (immune amnesia), making people who recover from the illness vulnerable to other infectious diseases.

Health officials have generally raised concerns about outbreaks of measles and other vaccine-preventable diseases as vaccination rates have slipped nationwide and vaccine exemptions have hit record highs. Anxiety over the risks has only heightened as Robert F. Kennedy Jr. is poised to become the country's top health official. Kennedy is a prominent anti-vaccine advocate who has spent decades spreading misinformation about vaccines.

Echo opinion in support of vaccines from Mount Desert Island Maine

An echo opinion published in the Maine "Mount Desert Islander" newspaper, by former State Senator Jill Goldthwait, in support of vaccines and the Maine Session 129, legislation LD 798, to remove philosophical exemptions that allows people to opt out without a medical reason for doing so.

Anti-vaxxers who oppose this public health bill are spreading outrageous lies about vaccines via Facebook. Outrageously, they are negatively impacting on the health of Maine people by spreading lies.  Read the story here.  "....spread of misinformation about immunizations has potentially fatal repercussions"

A bill before the Maine Legislature is embroiled in two classic arguments. How do we use science to support political decisions, and how do we balance our individual rights versus those of society? 

The preponderance of evidence supports protecting the public's health.

(MaineWriter - yes and I was among them....) 

AUGUSTA- Hundreds of Mainers showed up in Augusta last week to testify on LD 798, An Act to Protect Maine Children from Preventable Diseases by Repealing Certain Exemptions from the Laws Governing Immunization Requirements. The exemptions the bill would repeal are those based on “religious or philosophical beliefs.” The bill does continue to provide exemptions for those with medical conditions that make vaccination contraindicated.

The impetus behind the bill is outbreaks of childhood diseases thought to be eradicated, or nearly so, in the United States.

In 2000, measles was considered eliminated in the United States, but in 2019 in Washington state, more than 60 cases of measles were identified, more than the average number of cases reported in the entire country in a year. Fifty-four of those affected had not been immunized.

At one time, fewer than 20 cases of mumps were reported each year in the United States. In 2006, more than 6,000 cases were reported. A chicken pox outbreak occurred in 2012 in Indiana, sourced to an unvaccinated child. Here in Maine, we have the dubious distinction of the worst pertussis (whooping cough) rate in the nation. Reported cases more than doubled in month-to-month comparisons from last year to this. The greatest number of cases so far this year were in Hancock County.

An article in 1998 linked vaccinations to autism. Even though later discredited, it is still cited as the rationale for significant numbers of parents to opt out of vaccinations for their children, despite a study through the National Institute of Medicine at the National Institutes of Health finding no “causal association between MMR vaccine, or any other vaccine or vaccine constituent, and autism.”

The link between vaccinations and autism, particularly with the MMR (measles, mumps, rubella) vaccine, is labeled “critically flawed” by Children’s Hospital of Pennsylvania (CHOP).

In a vaccine safety publication, CHOP distinguishes between the terms “safe” and “harmless.” The latter, taken literally, is a test few life activities could pass. “Having been preserved from a real danger” is the safety definition CHOP finds most applicable, in that “a vaccine’s benefits must clearly and definitively outweigh its risks.”

Vaccines cannot be called 100 percent harmless, as there are certainly documented, untoward effects for some of those vaccinated. However, most are mild and innocuous, especially as compared to the effects of the diseases they prevent. Risks inherent in those diseases are far greater.

The other part of the vaccination debate is whether government has a right to intervene in a parent’s decision not to vaccinate his child. Parental rights are among the most protected in our society, but what about the rights of the rest of our kids to attend a school where the students are least likely to transmit childhood diseases by virtue of having been vaccinated?

Does a child with a known communicable disease have the “right” to go to school, putting all the other students at risk? Most often, symptoms become obvious only after a child has actually contracted the disease. They are exposing their friends, babysitters and schoolmates in the early days, already contagious but without the cough, fever or spots to make it apparent.

For the public hearing last week, 527 items were filed in testimony. All the testimony is posted online. There were pleas to require broad vaccination to protect those who, for medical reasons, cannot receive certain vaccines, as well as parents who felt that vaccination would adversely affect their children and opposed the bill.

Most Maine medical leaders were fully supportive. They are worth naming: The Maine Hospital Association, the public health director for the city of Portland, the Maine Children’s Alliance, the pediatric hospitalist at Maine Medical Center, the Maine Nurse Practitioner Association, the Maine Primary Care Association, the American Nurses Association, the American Medical Association, the American Academy of Pediatrics, the Maine Medical Association and other medical, educational and civic organizations.

Several health care providers, including a few physicians, did oppose the bill. Some opined that it is the pharmaceutical companies and the health care industry that promote vaccinations to enhance their bottom lines. The Maine Pharmacy Association was among those testifying in support.

It is difficult, if not impossible, for the average citizen to follow the detailed arguments and statistics presented by both sides. Most parents want nothing but what is best for their children, and most have decided that the benefits of immunization outweigh the risks. Unvaccinated children are also protected by those children who are vaccinated. The weight of the argument is in favor of vaccinating our kids for a healthier society.

jillgold@gwi.net  

Former Maine State Senator Jill Goldthwait is a registered nurse.