Unvaccinated school-age child dies of measles in Texas amid growing outbreak

An unvaccinated school-age child in Texas has died of the measles amid an ongoing outbreak in the state that has so far infected at least 124 people, mostly children, sending at least 18 to the hospital. Additionally, nine measles cases have been confirmed across the border in New Mexico. On Wednesday morning, the Lubbock health officials and the Department of State Health Services (DSHS) confirmed the death, which occurred within the last 24 hours. It is the first death in the mushrooming outbreak in Texas, and it marks the first measles death in the country since 2015, when a woman with underlying health conditions in Washington state died amid an outbreak. The death highlighted the importance of maintaining high community vaccination rates to prevent the spread of the extremely infectious disease to vulnerable people. Prior to that, the US hadn't recorded a measles death since 2003. In 2000, the US declared measles to be eliminated, meaning it no longer continuously spreads in the US. Outbreaks that occur have been limited and are generally sparked by cases linked to international travel. In the decade before the measles vaccine became available in 1963, it's estimated that 3 million to 4 million people were infected each year, leading to 48,000 hospitalizations, 1,000 cases of encephalitis (swelling of the brain), and 400 to 500 deaths annually, according to the Centers for Disease Control and Prevention. While the elimination of measles from the US through population-wide vaccination efforts is a public health triumph, the victory over the virus is eroding amid slipping vaccination rates nationwide. In 2019, the country narrowly avoided losing its elimination status after 1,274 cases were documented that year, largely from outbreaks in close-knit unvaccinated Orthodox Jewish communities in New York.

Ongoing outbreak

The current outbreak in Texas also involves a close-knit religious community—Mennonites—that has largely eschewed vaccination. The outbreak began in late January in Gaines County, which sits at the border with New Mexico. The county is one of the least vaccinated in the state, with coverage among kindergartners in the previous school year at just about 82 percent. That's significantly below the 95 percent threshold considered needed to prevent vaccine-preventable diseases from spreading in a community. Since the outbreak began in Gaines, cases have risen to 124, now scattered across a total of nine Texas counties. There are also nine cases across the border from Gaines in New Mexico's Lea County. It remains unclear how cases spread to the state. Of the 124 cases in Texas, 101 are in children, including 39 in children ages 0 to 4, some of whom may be too young to vaccinate. All but five of the 124 cases were unvaccinated. The CDC recommends all children get two doses of Measles, Mumps, and Rubella vaccine (MMR), one at 12 to 15 months of age and the second between the ages of 4 and 6. One dose is considered 93 percent effective at preventing measles, and two are considered 97 percent effective. Measles is one of the most contagious diseases known. The virus travels through the air and can linger in the airspace of a room for up to two hours after an infected person has been present. Among unvaccinated people exposed to the virus, 90 percent will become infected. In the US, about 20 percent of people with measles are typically hospitalized. Five percent develop pneumonia, and up to 3 in 1,000 die of the infection. Later in life, measles can also cause a fatal disease of the central nervous system called Subacute sclerosing panencephalitis. And the virus can erase immune responses to other infections (a phenomenon known as immune amnesia), making people vulnerable to various illnesses.