SEMINOLE, Texas — When Aganetha Unger arrived at the emergency measles testing center in her spacious white van, several of her eight children were exhibiting symptoms of illness.

“We’ve had some illness at home, nothing severe, just mild fever and some coughing,” Unger explained. One of her children experienced a high fever of 103 degrees.

The youngest of her children being tested was just 2 months old, snugly wrapped in a pink blanket on her mother’s lap. Despite the nasal swabbing by the EMS team, the baby didn’t cry.

It was Thursday, following the initial announcement of a measles outbreak in rural West Texas made by the Texas Department of State Health Services exactly eight days prior.

On Friday, confirmed cases surged to 49, nearly doubling from 24 reported earlier in the week, as stated by the state health authorities. Most of the infections are concentrated in Gaines County, which shares a border with New Mexico.

The majority of infections are among school-aged children, with 13 individuals requiring hospitalization. Notably, all those hospitalized are unvaccinated against measles, a highly transmissible virus.

Current case counts are likely an underrepresentation of the true scale of infection. Public health officials are racing to manage the outbreak, suspecting that between 200 and 300 individuals in West Texas may be infected but have not undergone testing, thus not contributing to the official statistics.

This rapid outbreak coincides with Robert F. Kennedy Jr.’s leadership of the Department of Health and Human Services. Kennedy has a history of skepticism towards vaccines, having fueled doubts about childhood vaccinations, particularly the measles-mumps-rubella (MMR) vaccine, wrongly associating it with autism.

During his confirmation proceedings, Kennedy asserted he is not anti-vaccine. “I advocate for safety,” he stated. “All my children are vaccinated and I believe vaccinations are vital in health care.”

The Health and Human Services Department did not provide a response to inquiries concerning Kennedy’s views on the outbreak.

The Centers for Disease Control and Prevention (CDC) can only deploy its experts if invited by the state. As of now, Texas has not made such a request, according to the CDC.

The CDC has dispatched around 2,000 doses of the MMR vaccine to Texas officials upon their request, primarily utilized to enhance immunity in partially vaccinated children rather than targeting the unvaccinated population.

Experts warn that without widespread vaccination efforts, this outbreak may persist for several months.

Measles Outbreak Epicenter

Seminole, the county seat of Gaines County, Texas, has emerged as the focal point of the current measles outbreak. Set in an expansive, flat region, it primarily comprises ranchers along with peanut and cotton growers.

A significant Mennonite community resides in the area—a religious group known for their belief in “complete separation from the outside world,” as noted by the Texas State Historical Association. This group partially selected Gaines County for its relaxed regulations concerning private educational institutions, including the absence of vaccine requirements.

According to health department statistics, Gaines County recorded one of Texas’s highest rates of vaccine exemptions for the 2023-2024 academic year—nearly 18%.

“We have a significantly high number of unvaccinated individuals,” remarked Tonya Guffey, the chief nursing officer at Seminole District Hospital. “It’s not that they lack education; it’s simply a matter of their beliefs.”

Guffey pointed out that many unvaccinated residents belong to the Mennonite community. “We provide education and encouragement; we do our best for the community, but ultimately, the decision is theirs,” she noted.

The pandemic seems to have contributed to a decline in vaccination rates.

“There’s a portion of unvaccinated individuals outside that community, and the Covid vaccine certainly impacted that,” Guffey continued.

A seasoned healthcare professional with over 30 years in the field and a native of Gaines County, Guffey expressed that she has never encountered a measles outbreak until now. Nonetheless, she was not taken aback by its scale.

“Given the large population of unvaccinated individuals, this outbreak is not unexpected,” she concluded.

Concerns in the ‘Hub’ City

Previously, measles cases were limited to rural regions surrounding Lubbock, Texas—the largest city nearby—until officials confirmed its first case on Friday afternoon.

Lubbock, often referred to as the “hub” city, hosts major grocery and retail stores.

Residents of Gaines County frequently travel to Lubbock for shopping and various activities, including many individuals without vaccinations who may have been exposed to measles.

“Communities that forgo vaccinations are not confined to their local areas; they often travel to Lubbock,” stated Dr. Ana Montanez, a pediatrician at Texas Tech Physicians in Lubbock. “In doing so, they risk spreading the virus.”

Dr. Montanez noted that several of her young patients were recently exposed, including one child who had shared a clinic waiting area with another confirmed case who had traveled in from another county.

To protect against measles, children typically need two doses of the MMR vaccine. The first dose is administered around age one, with the second following at age five, leaving a vulnerable gap in the years between doses.

However, physicians can choose to administer the second dose earlier if a child has been exposed to the virus, which is the approach Montanez has taken for some of her patients at risk. She continues to advise families on the benefits of vaccination.

At-Risk Young Population

The escalating outbreak has raised alarm for Carina Perez and her husband, Ben Ham, who are caring for a foster child affectionately known as “Muffin.”

The 18-month-old girl is only eligible for her first MMR vaccine dose so far. Born with several health complications, including reactive airway disease, she is particularly sensitive to respiratory viruses.

Muffin has been hospitalized in the intensive care unit three times due to respiratory syncytial virus (RSV) and even common colds.

“Even minor triggers can make her very ill,” Perez shared. “We must be extremely cautious about public outings.”