rewrite this title Unvaccinated Child Dies of Measles in Texas, Officials Say

A child has died of measles in West Texas, the first known death in an outbreak that is spreading in the region and in neighboring New Mexico, state health officials said on Wednesday.

The patient was an unvaccinated school-age child, according to officials in Lubbock, Texas, and the Department of State Health Services.

The outbreak comes amid growing concerns among public health experts about declining vaccination rates and the confirmation of Robert F. Kennedy Jr., a prominent vaccine skeptic, as the nation’s health secretary.

At a meeting of cabinet officials at the White House on Wednesday, Mr. Kennedy downplayed the news, saying that federal health officials were “watching” the outbreak and noting that there had been others this year.

“So it’s not unusual,” he said. He did not mention vaccination or describe steps the federal government might be taking to help stop the outbreak.

(Mr. Kennedy also asserted that there had been two deaths in Texas, although the authorities said there was just one.)

In “The Measles Book,” published by Children’s Health Defense, the anti-vaccine nonprofit he founded, Mr. Kennedy wrote that “measles outbreaks have been fabricated to create fear,” leading government officials to “inflict unnecessary and risky vaccines on millions of children for the sole purpose of fattening industry profits.”

As of Feb. 20, there had been three measles outbreaks in the United States this year and 16 last year, according to the Centers for Disease Control and Prevention. The outbreaks last year totaled 285 cases; this year’s tally so far is nearly half that.

Some experts objected to describing the outbreak as nothing unusual.

“Every single outbreak, illness, hospitalization and death is a tragedy, because it is entirely preventable with those vaccines,” said Dr. David Higgins, a pediatrician and preventive medicine expert at the University of Colorado Anschutz Medical Campus.

“Right now, what we need to be doing as a nation is rebuilding and building confidence in one of the greatest public health tools ever created,” he said.

Others cautioned against using last year’s outbreaks as a benchmark, noting that vaccination rates were already eroded then. “This is not normal,” said Dr. Cameron Wolfe, an infectious-disease expert at Duke University.

At least 124 cases of measles have been identified in Texas since late January, mostly among children and teenagers who were unvaccinated or whose vaccination status was unknown, Texas health officials said.

Eighteen have been hospitalized. This measles outbreak is the state’s largest in more than 30 years, said Katherine Wells, the director of public health in Lubbock, Texas.

Measles is a highly contagious respiratory illness that can be life-threatening to anyone who is not protected against the virus.

Doctors say the best way to protect against the disease is with two doses of a vaccine, which is usually administered to children as a combination measles-mumps-rubella, or M.M.R., vaccine. Two doses of the M.M.R. vaccine prevent more than 97 percent of measles infections.

Most of the cases have been centered in Gaines County, an area on the western edge of the state. It is home to thousands of Mennonites, an insular Christian group that historically has had lower vaccination rates. Officials said the child who died Wednesday had lived in Gaines County.

Last year, roughly 82 percent of the county’s population had received the M.M.R. vaccine. Experts say that at least 95 percent of people in a community need to be vaccinated in order to stave off outbreaks.

Public health officials believe the outbreak started in this community but has since fanned out to surrounding counties, where childhood vaccination rates lag significantly behind federal targets.

New Mexico has also reported an outbreak, with nine cases in Lea County, in the southeastern part of the state, on the Texas border.

Four of those cases are in children under the age of 18, all of whom are unvaccinated, according to Robert Nott, a spokesman for the New Mexico Department of Health. None of the cases in New Mexico have led to hospitalizations, he said.

The national immunization rate for measles, which fell during the Covid-19 pandemic, has not rebounded to the 95 percent required to stem the spread of measles in a community.

Just under 93 percent of children in kindergarten had the vaccine for measles, mumps and rubella in the 2023-24 school year, according to the C.D.C. Anti-vaccine campaigns have often targeted the M.M.R. vaccine.

“What’s most alarming to me is that we are seeing decreases in measles vaccination rates, especially in specific communities,” Dr. Higgins said. “And measles is so incredibly contagious that it spreads like wildfire when it gets into a community with a very low vaccination rate.”

The measles virus can linger in the air for up to two hours after an infected person has left the room. Each infected person can spread the virus to as many as 18 others.

The virus spreads when an infected person breathes, coughs or sneezes. Within a week or two of being exposed, those who are infected may develop a high fever, cough, runny nose and red, watery eyes.

Within a few days, a telltale rash breaks out as flat, red spots on the face and then spreads down the neck and torso to the rest of the body.

In most cases, these symptoms resolve in a few weeks. But in rare cases, the virus causes pneumonia, making it difficult for patients, but especially children, to get oxygen into their lungs, or brain swelling, which can cause lasting problems, like blindness, deafness and intellectual disabilities.

For every 1,000 children who get measles, one or two will die, according to the C.D.C. The virus also harms immune defenses, leaving the body vulnerable to other pathogens.

A 2015 study estimated that before widespread vaccination, measles may have accounted for as many as half of all infectious-disease deaths in children. Even now, the consequences can be serious. About 40 percent of people infected last year were hospitalized, according to the C.D.C.

Texas health officials have been encouraging people to get the M.M.R. vaccine with some success. Since Lubbock started holding clinics two weeks ago, health workers have vaccinated roughly 100 more people than they normally would, though attendance dwindled in the last two days.