Tracking US measles: Latest maps and cases

Measles continued to spread in Texas and New Mexico, spilling into nearby states in Oklahoma and Kansas. The outbreak is likely to last for a year, according to Texas health officials.

At least 847 confirmed or possible measles cases have been reported nationwide. It is associated with 759 outbreaks and 88 isolated cases and is usually linked to international travel. This year, there is the second highest number of confirmed cases since the US declared measles removed in 2000.

Measles infected 1,274 people in 2019, a major outbreak in New York’s orthodox Jewish community. There were multiple incidents in 2014, with a total of 667 confirmed cases.

Texas

The Texas outbreak began in late January when local health officials reported two incidents in Gaines County, a rural farming area on the western edge of the state.

The outbreak escalated quickly. Measles has spread to nearby counties and currently infected at least 597 people in Texas, including 575 unvaccinated children and adults. At least 62 people were hospitalized and two unvaccinated children have died. A school-age child in February and an 8-year-old girl in April, the first death in the US in 10 years.

New Mexico

New Mexico has declared an outbreak in Lee County, which borders Gaines County. The New Mexico incident has not formally linked to the Texas outbreak, but officials say it is “undetectedly related.” New Mexico has reported 63 cases in four counties.

Lear County unvaccinated residents who tested positive for the virus have yet to confirm that measles is the cause of death.

In both Texas and New Mexico, most measles cases are spreading among people who have not been vaccinated or whose vaccine status is unknown.

Kansas

Kansas reports 37 measles cases, including primarily unvaccinated children. One person was hospitalized. The first cases converge at the southwest corner of a state near the Oklahoma border, and genetic sequences suggest a link to the Texas and New Mexico outbreak.

Oklahoma

Oklahoma has reported 12 measles cases, but has not specified which county or county they have appeared in. The state health notice refers to the Tulsa area and Oklahoma City exposure locations.

Ohio

Ashtabula County, northeastern Ohio, has identified 10 outbreaks of measles cases associated with international travelers. This case does not appear to be related to the West Texas outbreak.

Another outbreak of 14 confirmed cases in Knox County was announced April 8th and linked to previous cases in that county.

Indiana

Allen County, northeastern Indiana, confirmed six outbreaks on April 9, but said “no links to outbreaks in other states are known.”

Pennsylvania

Erie County, northwest Pennsylvania, declared five linked incidents on April 14th. The state also reports isolated cases in four other counties, with at least two cases linked to the West Texas outbreak.

Michigan

Montcalm County confirmed three minor outbreaks of measles on April 17th. The Michigan Health Department said the outbreak was “initially linked to a large, ongoing outbreak in Ontario, Canada.”

New Jersey

The small outbreak in Bergen County, New Jersey began when an international traveler infected two close contacts. Outbreaks are no longer active.

Measles infection

Measles is one of the most contagious infectious diseases. In a fictional community where no one is immune and each of measles infects 18 others, a small outbreak quickly becomes out of control.

All vaccinators will help slow the spread of the virus and limit the outbreak.

For the outbreak to end quickly, each infected person must infect less people on average than the others. In this example, 17 out of 18 people will need to be vaccinated. Over 94% of the community:

And while measles symptoms often resolve on their own within a few weeks, in rare cases the virus can become extremely dangerous. It can cause pneumonia, making it difficult for a child to put oxygen into the lungs.

Infection can also lead to swelling of the brain, which can cause permanent damage, such as blindness, hearing loss, and intellectual disability. For every 1,000 children who get measles, one or two die, according to the Centers for Disease Control and Prevention.

The virus also causes “immune amnesia,” which prevents the body from protecting itself from diseases it is already exposed to, making patients more susceptible to future infections.

When someone contracts the virus, doctors have little control over how serious the measles infection can be. It does not have antiviral properties to stop the spread of measles in the body, and only supports “supportive care” to manage symptoms. Therefore, experts recommend administering two doses of 97% MMR vaccines to prevent infection.

Measles was officially declared to have been eliminated – meaning that the virus has not been spreading continuously – in 2000 there was a large part due to an aggressive vaccination campaign. Now, experts fear that status could be at risk as vaccination rates decline nationwide.

Vaccination rates

For years, Gaines County had low childhood vaccination rates, primarily due to the large Mennonite community in the area. Although there are no religious doctrines that explicitly prohibit vaccines, the island’s Christian groups historically have a long tradition of avoiding interaction with the health care system and using home remedies and supplements.

Approximately 82% of kindergarten students in the county were receiving the Measles-Munz-Rubella vaccination (MMR) last year.

Texas public schools require children, including MMR shots, to receive a specific vaccine, but parents can apply for an exemption for “reasons of conscience” including religious beliefs. Last year, Gaines County had one of the highest exemption rates in the state.

Vaccination rates may vary widely from school district to school. The Loop Independent School District in Gaines County is a small district with one school and the lowest measles vaccination rate in Texas County affected. Only 46% of kindergarten students received the MMR vaccine in 2023, down from 82% in 2019.

In Lee County, NM, the MMR vaccination rate for children and teens is relatively high, at around 94%. However, the proportion among adults is much lower. 63% received one shot of MMR, and local health officials said that only 55% received both shots, but that there may be some adults who have been vaccinated without any records added to the system. Adults account for more than half of the cases reported in New Mexico.