Pediatrician working in the heart of Texas measles outbreak warns it’s ‘just the beginning’ with cases surging to 90

A pediatrician working in the heart of Texas’ measles outbreak says the country should expect to see cases surge as more unvaccinated people get infected.

The outbreak in the South Plains region of Texas has recorded about 90 cases of the virus, including 16 hospitalizations – all of children – and all but five of the people currently sick have been vaccinated against the measles.

Dr Lara Johnson, a pediatrician and chief medical officer at Covenant Children’s Hospital in Lubbock, Texas, said she saw the first measles case in her community about one month ago.

Now, she’s warning this is just the ‘beginning of the outbreak, and ‘we’re going to see a lot more illness among unvaccinated kids over the next few months.’

Dr Johnson revealed most of the young patients are being hospitalized for breathing difficulties and are in need of supplemental oxygen, while others have very high fevers, which can be fatal in young children.

The outbreak is the state’s largest in nearly 30 years and has been concentrated in what Texas Department of State Health Services spokesperson Lara Anton called a ‘close-knit, undervaccinated’ Mennonite community. 

The measles vaccine (MMR) is 97 percent effective as preventing the virus and is required for children to attend school, but some states allow exemptions based on religious reasons. 

Across the country, the percentage of children seeking exemptions has risen over the past decade, from 0.76 percent in 2014 to 3.3 percent during the 2023-2024 school year.

According to the CDC, for that school year, vaccination coverage among kindergartners entering school declined for all shots – down to 93 percent for MMR, though that number varies widely across the country. 

The Texas Department of Human and Health Services reports 91 percent of kids had received the MMR.  

Ninety-four percent coverage is considered the standard for herd immunity.

Dr Johnson says she feels ‘lucky’ as her two children are older and have been vaccinated. 

She wrote for Business Insider: ‘Two doses of the measles vaccine [given at 12 to 15 months and again between 4 and 6 years] prevent 97 percent of measles cases, so I’m not worried about them.’

Children too young to receive the vaccine depend on older kids able to be vaccinated to protect them – the concept of herd immunity. 

However, with the outbreak spreading in Texas, she says it is best to keep vulnerable children ‘out of the grocery store and crowded places as much as possible’ and ‘if you’re worried about your baby, call your pediatrician.’

From her experience, Dr Johnson says parents of vaccinated children shouldn’t be overly concerned as they are ‘very unlikely to get it.’

But for parents of unvaccinated children, she says the telltale sign of the virus is a rash which starts on the face. If you see this, immediately call your pediatrician, Dr Johnson advises.

She also writes it isn’t too late for children to get a vaccine – even after exposure.

The medical expert explains: ‘If a dose of the vaccine is administered within three days, you can still drastically reduce your chance of getting measles. 

‘This is called post-exposure prophylaxis (PEP). We’re offering vaccination to as many unvaccinated people as possible, including the family members of hospitalized children.’

Measles is one of the most contagious infectious diseases. 

One infected person can spread the infection to 12 to 18 other people in an unvaccinated population. 

Much of the outbreak in Texas is centered in Gaines County, which has reported 57 cases. 

Health officials said that because of its high transmissibility, additional cases are likely to occur in Gaines County and the surrounding communities. 

Meanwhile, Terry County to the north has 20 cases, Dawson County has six, Yoakum County has four, and Lubbock, Ector and Lynn counties all have a case each.

Gaines county, with a population of just 21,598, has one of the highest rates of vaccine exemptions in the state and all of the confirmed cases are in unvaccinated people.

Measles is caused by a virus that spreads through respiratory droplets produced when an infected person talks, coughs, or sneezes. Measles virus can stay in the air or on surfaces for up to two hours after an infected person has left the room.

Symptoms typically appear between seven to 14 days after contact with the virus. It can cause a high fever that can be life-threatening, a red rash, cough, fatigue, and watery eyes.

In some cases, the infection can also cause sensitivity to light, pneumonia, and brain swelling.

One in five children who become infected end up in the hospital, with one in 15 developing serious complications like meningitis or sepsis.

Approximately five percent of children with measles may develop pneumonia, which is the most frequent cause of death in young children with measles.

Additionally, around one in 1,000 children who contract measles may experience brain swelling, or encephalitis, leading to convulsions and potential consequences such as deafness or intellectual disability.

For every 1,000 children who get measles, one or two will die from it.

Measles was declared eliminated in 2000 thanks to the highly effective MMR vaccine, but the declining rates in childhood vaccinations has meant outbreaks occur every year.

Before the vaccine was introduced in 1963, the US saw 3million to 4million cases per year. Now, it´s usually fewer than 200 annually.

The US saw a rise in measles cases in 2024, including an outbreak in Chicago that sickened more than 60.

Addressing the anti-vax movement, which she knows exists in and around her community, Dr Johnson concludes: ‘Vaccines can be polarizing, and there’s no magic way to address communities that have strong anti-vaccine sentiments. 

‘As pediatricians, our job is to speak the truth about vaccines: they are safe and effective. We hope that families are willing to hear that.’