DALLAS — Measles cases are rising in Texas, prompting health warnings in San Antonio, New Braunfels, and San Marcos.

The Texas Department of Health and Human Services has confirmed 90 cases to date, with 16 individuals hospitalized due to the illness.

Experts in public health suspect that the actual case number might be even higher.

“What you’re observing is merely the tip of the iceberg,” noted Dr. Diana Cervantes, an Associate Professor of Infectious Disease Epidemiology at the University of North Texas Health Science Center.

Measles is recognized as “one of the most contagious diseases in existence,” according to Dr. Suzanne Whitworth, Division Chief of Pediatric Infectious Diseases at Cook Children’s in Fort Worth.

“We know that approximately 40% of children under five years old who contract measles will end up hospitalized, and that’s something we want to avoid,” Whitworth explained.

The outbreak began in Gaines County on February 5, when an individual with a measles infection traveled to Texas State University, the University of Texas San Antonio, the Riverwalk, and a Buc-ee’s during the Valentine’s Day weekend. Following that event, additional cases were reported in Dawson, Ector, Lubbock, Lynn, Terry, and Yoakum Counties. The virus has also spread to New Mexico, which has reported nine cases.

According to the Centers for Disease Control and Prevention (CDC), measles is a highly transmissible virus that can lead to severe health issues. The CDC states that “anyone unprotected against measles is at risk,” emphasizing that receiving two doses of the MMR vaccine offers the most effective defense against this virus.

• A rash characterized by red, flat spots that starts on the face and spreads across the body
• High fever, potentially exceeding 104°F
• Persistent cough
• Runny nose
• Red, watery eyes

Measles spreads through air and respiratory droplets when an infected person breathes, coughs, or sneezes, as outlined by the Texas Department of State Health Services. The measles virus can remain airborne and infectious for up to two hours after an infected individual has left the area.

Symptoms of measles typically manifest between one to two weeks post-exposure. Notably, those infected can be contagious for about four days before displaying any symptoms.

Dr. Carla Garcia Carreno, Director of Infection Prevention and Control at Children’s Medical Center Plano, stated, “The incubation period for measles spans approximately 8 to 14 days, but it can vary from 7 to 21 days.” She added, “Individuals can be infected without showing symptoms for up to 21 days, and they remain contagious from four days prior to the rash’s appearance until four days after. Therefore, it’s crucial to be aware that early symptoms may resemble those of the flu, leading people to unknowingly spread the virus.”

The Texas Department of State Health Services offers advice for those who might have been exposed to the measles virus.

• Stay at home from work or school and avoid public places until four days after the rash appears
• Isolate yourself, particularly if you have not been vaccinated against measles
• Contact your healthcare provider for testing before visiting in person
• Unvaccinated children should stay out of schools and daycare facilities for at least 21 days following exposure to a measles case, in accordance with Texas regulations

For further details on school absence policies and return dates in Texas, click here.

Dr. Whitworth reassures individuals who have been vaccinated, stating they “should be fine” if present at the aforementioned college campuses or restaurants during the outbreak. However, she recommends that unvaccinated or immunocompromised individuals consult their doctors for advice.

If symptoms such as fever, runny nose, conjunctivitis, or a rash develop during the 21-day window, but are mild in nature, Whitworth suggests contacting a healthcare provider prior to attending a clinic or emergency room to minimize exposure risks.

Measles can lead to serious health complications, particularly for young children under five years of age. Common issues include ear infections and diarrhea, while more severe complications can entail pneumonia and encephalitis, as highlighted by the CDC.

“This age group sees the majority of hospitalizations and complications, particularly among those who are unvaccinated. Most adults are immune due to vaccinations, which is why we’ve observed fewer cases historically,” explained Dr. Carreno.

Additionally, hospitalization risks and complications during pregnancy have been documented. Populations at higher risk include pregnant women and individuals with compromised immune systems, like those living with leukemia or HIV.

Per CDC guidelines, measles was officially eliminated in 2000 and has rarely been observed since. Vaccination remains the most effective form of prevention.

The CDC advises that children receive two doses of the MMR (measles, mumps, rubella) vaccine—the first between 12 and 15 months of age and the second between four and six years. The second dose can be given earlier, at least 28 days after the first.

For students enrolled in post-high school educational institutions, the recommendation is to receive two doses of the MMR vaccine, spaced at least 28 days apart.

Adults who haven’t received the vaccine are advised to get at least one dose of the MMR vaccine.

For more details on the vaccination schedule, visit https://www.cdc.gov/vaccines/vpd/mmr/public/index.html.

Dr. Whitworth urges families with infants too young for vaccination to take extra measures to avoid potential exposure.

“Ensure that parents, siblings, and even grandparents are current on their vaccinations. Keep infants away from anyone showing signs of respiratory illness, such as a cough, runny nose, or rash,” she advised. “Avoid contact with sick individuals.”

Whitworth reminds families of the lifesaving impact of vaccines. “This vaccination is among the essential immunizations, especially considering measles is one of the most contagious diseases. If you think you may have been exposed, ensure you isolate yourself and monitor for symptoms, as the virus can be transmitted even if you are asymptomatic or prior to developing a rash. Staying informed through reputable sources is crucial during this time,” Dr. Carreno stated.