Measles outbreak likely larger than reported, experts say

The growing measles outbreak centered in West Texas has now spread into New Mexico and Oklahoma, making it the largest outbreak in the country in six years. With over 250 reported cases across the three states, public health experts believe that the actual number of cases is likely much higher.

Katherine Wells, the director of public health in Lubbock, Texas, where some sick children have been hospitalized, expressed concerns about unreported cases. She mentioned that individuals do not have to come in and get tested for measles, making it difficult to accurately gauge the extent of the outbreak. Wells emphasized that it will be a long and challenging process to eliminate measles from the area.

The recent death of an unvaccinated child from measles in Texas, the first measles-related death in the country in a decade, has raised alarms among experts. In New Mexico, health authorities are investigating another possible measles fatality. The fatality rate for measles is estimated to be around one to three deaths per 1,000 cases, indicating that the number of cases could be much higher than reported.

Epidemiologist Katelyn Jetelina, who has been tracking the outbreak, noted that the deaths in such a small number of cases are concerning. The reluctance of some individuals to seek testing, combined with distrust of public health efforts and logistical challenges in accessing testing, has contributed to underreporting of cases.

The outbreak is occurring in a rural area of Texas, making it difficult for people to access testing facilities. Some individuals may be choosing to stay at home if they are not severely ill, further complicating efforts to track the spread of the virus. The high number of adult cases in Texas and New Mexico reflects a shift in measles demographics, with more adults now being affected.

While more than half of the confirmed cases in Texas are in Gaines County, tied to a Mennonite community with low vaccine uptake, cases have also been reported in counties across a 300-mile stretch from south to north. Oklahoma has also reported probable measles cases linked to the outbreak.

Health officials stress the importance of tracking as many cases as possible to contain the outbreak effectively. Despite the challenges posed by underreporting and lack of cooperation, efforts are ongoing to control the spread of measles in the region. As the measles outbreak continues to spread, there is a growing need for stronger surveillance measures to effectively track and contain the virus. With improved surveillance, health authorities can pinpoint areas with high infection rates and target them for additional testing and vaccination campaigns. This targeted approach is essential for safely corralling outbreaks and preventing further spread of the disease.

The outbreak has not only posed a public health threat but has also taken on a political dimension. In a recent interview with health secretary Robert F. Kennedy, Jr., Fox News’ Sean Hannity downplayed the severity of the outbreak, referring to it as “relatively small.” Kennedy, who has previously downplayed the importance of vaccination, reiterated that there are multiple measles outbreaks every year. However, it is crucial to note that an outbreak is defined as three or more connected cases, and even a small number of infections can have serious consequences.

During the 2018-2019 measles outbreak in New York City, former assistant commissioner Jane Zucker observed a shift in people’s willingness to get tested. Contrary to usual behavior during an outbreak, where people actively seek confirmation of the virus, many individuals were hesitant to get tested during this outbreak. This reluctance led to delayed identification of measles cases, hindering the implementation of timely control measures by the health department.

In a publication in the New England Journal of Medicine, Zucker and her colleagues highlighted the challenges faced during the outbreak, noting that some infections were only reported weeks to months later when parents brought their children in for serologic testing. This delay in identifying cases impeded the department’s ability to implement real-time control measures and prevent further transmission of the virus.

To effectively combat measles outbreaks, it is essential to strengthen surveillance efforts, expand testing in high-risk areas, and prioritize vaccination outreach. By utilizing data-driven strategies and targeted interventions, health authorities can contain outbreaks and protect vulnerable populations from the impact of the disease. It is crucial to learn from past experiences and implement proactive measures to ensure the timely and effective management of future outbreaks.