, 2025-04-16 20:06:00
The US Centers for Disease Control and Prevention (CDC) and the state of Texas are struggling to contain growing measles outbreaks in the face of declining support from the federal government, said a CDC official at a meeting of the agency’s Advisory Committee on Immunization Practices (ACIP) on Tuesday.
Even as the Texas-centered outbreak continues to expand, some 25 states are reporting measles cases, said David Sugerman, MD, of the CDC’s National Center for Immunization and Respiratory Diseases.
“We are scraping to find the resources and personnel needed to provide support to Texas and other jurisdictions,” Sugerman told ACIP members.
Sugerman noted that the CDC and state responses had become more difficult since the federal government had canceled some $11 billion in COVID-19-related grants to states to help track and control infectious diseases.
“There are quite a number of resource requests coming in, in particular from Texas,” he said. Each measles case response costs an estimated $30,000-50,000, said Sugerman, adding, “that adds up quite quickly.”
The CDC sent 15 experts to Texas earlier in the outbreak and deployed another seven on April 15, said Sugerman. Workers have assisted with infection control, risk mitigation, communications, developing a dashboard to track cases, and technical assistance for lab testing and genomic sequencing.
The Texas Department of State Health Services said on Tuesday that 561 cases had been reported since January, an increase of 20 since the department’s last update on April 11. Only 11 of the infected individuals had received at least one of the two recommended measles, mumps, and rubella (MMR) vaccine doses; 550 were either unvaccinated or had an unknown vaccine status. Ten counties have ongoing measles transmission.
There have been 58 hospitalizations and two deaths, both in children who were unvaccinated. An adult in New Mexico tested positive for measles after death.
The numbers of infections are likely an undercount. “We do believe that there is quite a large amount of cases that are not reported,” said Sugerman, who added that some individuals who have recovered were never tested, and others never sought treatment.
The outbreak began in a close-knit community in Gaines County, Texas, and has spread to 21 additional Texas counties and to New Mexico (56 cases), Oklahoma (7 cases), and Kansas, said Sugerman. Large outbreaks are also occurring in similarly close-knit communities in Ontario Canada and Chihuahua, Mexico, he said. Genomic sequencing indicates the virus in those communities is a similar lineage to what is circulating in Texas, said Sugerman.
Only 82% of children in Gaines County public schools had received the recommended two doses of MMR vaccine, he said. The true vaccine coverage percentage in the area is unknown as many children are home schooled or attend private schools that do not report, Sugerman said.
Ninety-five percent coverage is required to prevent outbreaks, he said. Vaccine coverage has been declining nationally. In the 2023-24 school year, MMR vaccine coverage was 92.7%; about 7% of kindergartners— some 280,000 — did not have documentation of two MMR doses, according to a CDC report.
Before the introduction of the measles vaccine in 1963, some 3-4 million Americans were infected each year, said Sugerman.
Since 2000 — when measles was declared eliminated in the US — there have been 11 large outbreaks with more than 50 cases, mostly in communities with low vaccine coverage, said Sugerman. Seven have occurred in the last 5 years, he said.
Cases rose from 59 in 2023 to 285 in 2024. So far, there are 712 in the first 4 months of 2025, Sugerman said.
“There’s no reason why we have healthy children dying of measles in the US,” said ACIP chair Helen K. Talbot, MD, MPH, professor of medicine and health policy, Vanderbilt University, Nashville. “This [MMR] vaccine is amazing,” she said. “It’s highly effective, and very long lasting.”
Talbot reported that she had no conflicts of interest.
Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in many health and science publications, including Smithsonian.com. You can find her on X @aliciaault and on Bluesky @aliciaault.bsky.social.