A poster at a medical centre warns against the spread of measles. Photo: RNZ / Rob Dixon
By Neha Mukherjee, CNN
The first measles death in the growing outbreak in West Texas was a school-aged child.
The child was unvaccinated and had been hospitalised in Lubbock, Texas, said Lauren Adams, Lubbock city spokesperson.
Officials did not answer questions regarding the patient's specific age, any other health issues, or details about the patient's schooling in a press conference jointly hosted by Covenant Health and the City of Lubbock Public Health on Wednesday local time.
This is the first US measles death since 2015, when a woman in Washington state died.
The number of confirmed measles cases reported in an outbreak in West Texas is now at 124, the Texas Department of Health Services said in an update Tuesday, an increase of 34 since late last week. Most of the cases are in children ages 5 to 17.
At President Donald Trump's first cabinet meeting on Wednesday, he deferred a question about the measles outbreak in Texas to Robert F. Kennedy Jr., secretary of the US Department of Health and Human Services, who said, "We are following the measles epidemic every day."
Kennedy said during the cabinet meeting that there had been two measles deaths but Texas officials confirmed Wednesday afternoon there has been only one death. New Mexico officials said no measles deaths have been reported in the state.
Robert F. Kennedy Jr. claimed there were two measles deaths, but officials say there has only been one. Photo: Olivier Touron / AFP
Eighteen people have been hospitalised so far in the outbreak. All have been unvaccinated.
Kennedy said that hospitalisations were "mainly for quarantine" but local health officials told CNN most patients were admitted for respiratory issues.
"We don't hospitalize patients for quarantine purposes," said Dr. Lara Johnson, the chief medical officer of Covenant Health Lubbock Service Area. "Quarantine is not something that would happen in a healthcare facility. We admit patients who need acute supportive treatment in our hospital."
"Patients have been needing supplemental oxygen and respiratory support to help them get over viral pneumonia linked to the measles," Johnson told CNN Chief Medical Correspondent Dr Sanjay Gupta last week.
It's not clear why Kennedy said there were two deaths. In a response to questions from CNN about Kennedy's comments, HHS Director of Communications Andrew G. Nixon said the US Centers for Disease Control and Prevention "is aware of the death of one child in Texas from measles, and our thoughts are with the family.
CDC continues to provide technical assistance, laboratory support, and vaccines as needed to the Texas Department of State Health Services and New Mexico Department of Health, which are leading the response to this outbreak."
Kennedy also referenced past measles outbreaks saying, "So it's not unusual. You have measles outbreaks every year."
In the press conference Johnson commented, "The United States had really gotten to a point where we just didn't see these kinds of outbreaks happening. Obviously, that has changed over the last 20 something years, and so we do see outbreaks more frequently, but that that is related to how much we're vaccinating our population."
"When we think of about vaccine preventable illnesses, they're only preventable if we have adequate vaccination rates," said Johnson.
The bulk of the cases, 80, remain in Gaines County, where the outbreak began, but there has also been spread to eight additional counties. Most of the cases are in people who were unvaccinated or whose vaccination status is unknown. Five cases were reported in people who said they have been vaccinated.
Measles is an airborne illness that can cause rash, fever, red eyes and cough. Severe cases can result in blindness, pneumonia or encephalitis, swelling of the brain. In some cases, the illness can be fatal.
The bulk of cases were in people who were unvaccinated. Photo: 123rf.com
While details on the specific death in Lubbock are still unknown, experts have long warned that measles complications that can result in death in children.
Up to 3 out of 1000 children with measles will die from respiratory or neurological complications, according to the US Centers for Disease Control and Prevention.
Specifically, 1 in 20 children with measles will develop pneumonia, the most common cause of death from the disease, according to Dr. Catherine Troisi, an infectious disease epidemiologist with UTHealth Houston who was not directly involved with the Lubbock patient.
"These outbreaks last between two to six months. That's a long time. That's a lot of kids infected … death is rare, but tragic when it happens, but there are a lot of other sequelae, encephalitis, for example, and deafness. There's a rare neurological disease that can happen. So, as you have more people infected, these sequelae become more common."
The best way to stay protected against measles is to get vaccinated with the measles-mumps-rubella (MMR) vaccine, according to experts.
The Lubbock department of health has opened free vaccination clinics which have given about 70 vaccinations since the start of the outbreak, according to city officials.
Coverage of the measles, mumps and rubella (MMR) vaccine is particularly low in Gaines County, where nearly 1 in 5 incoming kindergartners in the 2023-24 school year did not get the vaccine. Other affected Texas counties also fall below a goal of 95 percent, set by HHS, that's necessary to help prevent outbreaks of the highly contagious disease.
Given how contagious measles is, health officials warn that cases may continue to rise in West Texas.
"I very rarely say I'm 100 percent sure of something, but I am 100 percent sure we will see an increase in cases… Texas as a state is under vaccinated, so there are susceptible people," Troisi said. She also worries because of the contagious nature of the disease: People don't show symptoms before they become infectious, and the virus can stay in the air for up to two hours, even after a person with the virus leaves the area.
"Measles is the most infectious virus we know. However, it's a harbinger of low vaccination rates, and it is quite likely we will start seeing outbreaks of other diseases that are vaccine preventable as well as these vaccine rates decrease," Troisi said.
Even the 124 cases identified in Texas are likely an undercount, according to Dr. Peter Hotez, co-director of the Texas Children's Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine.
He says some children may not be seeking medical care or could still be waiting for laboratory confirmation. Texas health officials have listed several public spaces, including a university campus, a museum and convenience stores, where measles exposures may have occurred in recent weeks.
Hotez worries specifically about an upcoming rodeo in Houston that draws families from West Texas.
"It will continue as long as the virus continues to find unvaccinated kids. And unfortunately, the vaccination rates in many counties in West Texas are still unacceptably low. So that's why I think it could go on for a while," Hotez said.
