With more than 42 days elapsing since a case of measles was reported in the state’s designated outbreak area, the Texas Department of State Health Services (DSHS) officially declared an end to the West Texas measles outbreak.
However, DSHS’ press release announcing the end of the outbreak, as well as Texas Medical Association leaders, warn that the official declaration does not mean the threat of measles is over. The state announcement cites ongoing outbreaks of measles in North America and globally, which likely means there will be additional cases of measles this year in Texas.
“There’s never a good time to let your guard down when it comes to something that is as exquisitely contagious as measles,” said past Texas Public Health Coalition chair Jason Terk, MD, former chair of TMA’s Council on Science and Public Health, Council on Legislation, and Committee on Child and Adolescent Health.
Dr. Terk likened the conditions that propagate an outbreak to those for seasonal wildfires. “If you have a fire that you put under control, it doesn’t necessarily decrease the likelihood that you’re going to have another fire in the near future, because the conditions haven’t really changed.”
The outbreak’s toll was stark – 762 cases of measles were confirmed between late January and Aug. 18, according to DSHS data. Nearly 100 people were hospitalized, and two fatalities occurred in school-aged children. The outbreak was also costly from a fiscal standpoint. The state health department reports spending between $8 million and $9 million to mount its response, and TMA staff say it remains unclear how much of that might be reimbursed by the Centers for Disease Control and Prevention (CDC).
As the outbreak wore on, vaccine recommendations in counties in the designated outbreak area were adjusted temporarily to better protect groups at higher risk of exposure. DSHS provides current guidelines for routine measles, mumps, and rubella (MMR) vaccination. All individuals without proof of immunity or sufficient immunization are recommended to receive the appropriate doses of the MMR vaccine.
Dr. Terk, a pediatrician in Keller, says pockets of inadequately vaccinated populations, including in schools or close communities, still present “ready-made situations that are likely to have another flare of measles again, because the conditions are not different.”
In its Annual Report of Immunization Status of Students, DSHS reports that for the 2024-2025 school year, 93.24% of Texas kindergarten students had received the MMR vaccine, below the 95% community immunity threshold. But Dr. Terk emphasizes the role of identifying data in specific schools and districts as areas where physicians can continue to better understand the factors that lead to vaccine hesitancy.
“It really is more about the wide variability in vaccine coverage that you see in certain parts of the state and even certain regions within the state,” Dr. Terk said. “It’s much more helpful to consider the lack of homogeneity of coverage across the state.”
DSHS’ report also includes a map with counties shaded by the percentage of K-12 students with a conscientious exemption and a breakdown of students’ vaccination levels across the state’s eight public health regions.
No one patient education technique will sway parents who are on the fence about inoculating their children against measles, Dr. Terk says. But the common denominators in the conversations he initiates include:
- Hearing parents’ concerns;
- Reminding parents that he and they are on the same team – supporting the health and welfare of their child;
- Adopting a permission-seeking and nondidactic approach; and
- Using careful, respectful phrasing. For example, “I want to make sure that I’m doing my best for the sake of your child in answering your questions and responding to your concerns. Would you mind sharing that with me?”
Applying those guardrails to a conversation, he said, can help you “go from ‘I’m not so sure I want to do this’ to a ‘Yes, I’m willing to have this conversation.’ And that sort of changes the whole milieu that you can have in that sacred space between the patient and the parent and the doctor.”
Physicians are encouraged to stay vigilant on being familiar with recognizing and diagnosing measles symptoms, especially as we move into respiratory illness season, to protect their patients, themselves and their communities. To stay up to date with measles’ occurrence in Texas and associated resources, visit TMA’s Measles Resource Center.
Jessica Ridge
Reporter, Division of Communications and Marketing
(512) 370-1395