Most communities can rest assured that they are protected from measles due to high vaccination uptake rates – it's the areas with populations of unvaccinated people where this highly contagious respiratory virus could cause problems, says Dr. Jill Weatherhead, assistant professor of infectious diseases and tropical medicine at Baylor College of Medicine.
Particularly to the populations that are at increased risk of severe infection such as children who are younger than five years old, pregnant women and people who are immunocompromised, she says.
Measles, similar to other respiratory viruses, can be transmitted through respiratory droplets, which can remain in air and infect those who come into contact with contaminated surfaces. This virus presents symptoms that are flu-like in manner; but progress to include a severe rash from the head to the back of the body, Koplik spots or little white dots on the inside of the throat and a high temperature.
In some severe cases, measles can lead to death if there is co-infection with pneumonia – especially in young children – or can trigger encephalitis, the swelling of the brain, Weatherhead says.
According to the Texas Department of State Health Services, the most recent detected case of measles was found in a child last week from Hood County in North Texas, southwest of Fort Worth.
Before that, The last time a case of measles was recorded in Texas was in 2019, when there was a larger outbreak linked to international travel. However, in last week's case there were no recent trips or known exposures to a person who was already infected.
Weatherhead said the department will likely conduct an investigation to determine what could have led to infection, especially to evaluate the risks that may be involved, “The concern in that community where the patient has been is whether or not this will be an isolated case,"
“In Texas, we have quite a few regions where vaccine uptake is not sufficient to prevent community transmission – so we could see a lot more cases come out of this,” she said.
Many adults have their two doses of the MMR vaccine – the immunizations to protect against the virus, and two other diseases, mumps and rubella – that the Centers for Disease Control and Prevention recommend, or they’ve built immunity by infection before.
However, Weatherhead said there is a reduction in the number of people getting their children vaccinated amid the rise in anti-vaccination culture and the difficulty of accessing health care during the pandemic.
“It’s these younger children – where people who are not getting their children vaccinated – that are at the greatest risk because we may see more of those cases since they haven’t received vaccines or haven’t been infected with measles from prior exposure,” she said.
The percentage rate of kindergarteners who received their immunizations against measles in the state decreased one percentage point over the last calendar school year – from 95 percent in 2020-2021 to 94 percent in 2021-2022. Although this may seem like a small measure, this meant more than 80,000 of the more than 5 million students included in the study were unvaccinated due to religious exemptions, medical exemptions or because they were behind on their vaccinations, according to the Texas DSHS annual immunization report
The CDC recommends two doses of the MMR vaccine, one dose given to a child when they are between 12 to 15 months old and a second, between four and six years old.
A single dose of this vaccine alone is 93 percent effective against measles, and two together increases that to 97 percent, whereas without these immunizations an infected person could transmit their illness to between 12 and 18 unvaccinated people, Weatherhead said.
According to the CDC, at least 1 in 5 unvaccinated patients will require hospitalization. But, doctors there are only able to provide "supportive treatment" similar to how they approach treatment for Respiratory Syncytial Virus — because there is no antiviral in circulation or used by medical professionals to help treat measles.
Doctors can use oxygen if those infected are having difficulty breathing or provide albuterol – a medication used to prevent and treat wheezing, chest tightness and coughing caused by asthma and other respiratory diseases.
Although cases remain low in the United States, with a total of 16 known cases in 11 different areas across the country, Weatherhead said this virus is “the most contagious virus that the medical world knows of.”
“For the most part, if you are vaccinated, the chance of you getting the virus is next-to-none and outside of that if people continue to get vaccinated the likelihood that there will be circulating measles in our community is very low,” Weatherhead said.