This young Texas doctor only read about measles. Now she's a leading expert amid outbreak.
Dr. Leila Myrick had only read about measles in medical school before a girl with the telltale rash turned up in her West Texas emergency room in late January.
The child, who had no immunity to the highly contagious disease but had an underlying respiratory condition, would become one of the first known cases in Gaines County, the epicenter of the nation's largest outbreak, in six years. Nearly 160 known people have been infected since, including 22 people who have been hospitalized. And last week, a school-aged child with no underlying conditions died, marking the first measles death in a decade. The outbreak spread across rural counties and is now suspected to have caused an outbreak nearby in New Mexico.
Myrick, a 38-year-old family medicine and obstetrics physician in the tiny town of Seminole, looked back to medical texts to learn more about the disease, once thought to be nearing eradication in the U.S. Now, she's treated nearly a dozen cases and counting. In just over a month's time, the rural doctor has become one of the nation's only doctors with firsthand experience of how infectious, and serious, measles is. And she is an unwitting expert in a disease she never thought she'd treat.
'Now we're literally seeing when you don't vaccinate, this is what happens,' Myrick said.
Since vaccination rates have dropped across the U.S., doctors and health staff across the country are rethinking preventable diseases such as measles that hadn't been seen in generations.
The U.S. declared measles eliminated in 2000. But American immunization rates have decreased in schools — which normally require vaccines for attendance — below the 95% herd immunity threshold needed to prevent outbreaks, according to the Centers for Disease Control and Prevention. Drops have been attributed to distrust and misinformation around public health and vaccination that led to increases in medical or religious exemptions.
'Measles is the tip of the iceberg,' said Dr. Daniel Kuritzkes, chief of the infectious diseases division at Brigham and Women's Hospital and a professor at Harvard Medical School. 'There are other vaccine-preventable illness that we could see recurring, which could also have catastrophic consequences.'
In Gaines County, just over 80% kindergartners were vaccinated against measles last school year. In the county, Loop Independent School District, with about 150 students, had less than half of students vaccinated.
As of Tuesday, over 100 of Texas' 159 cases were in Gaines County. Most cases are in children, predominantly among those who are school-aged. All but five cases were among people who weren't vaccinated or had no known vaccination status.
Five years ago, Myrick moved from her hometown of Atlanta — after studying at Emory School of Medicine and earning a doctorate in neuroscience in addition to her medical degree — to Seminole, where peanuts, oil, natural gas and cotton dominate the Texas plains. Instead of Atlanta's famed research institutions, including CDC headquarters, Myrick sought to practice treating families as a rural doctor. She moved her family to Seminole, population 7,231, where she liked the diversity. It is a mix of white, Mexican and Mennonite families and sits about 80 miles southwest of Lubbock.
She and her husband are raising two children, ages 5 and 8, who attend local schools. Her in-laws live across the street. Seminole is like a village, she said. People look out for each other and their children.
Her commute to work is a 3-minute drive with one traffic light − short enough that she doesn't even bother to turn on the radio. At her local grocery store, people stop her in the aisles with medical questions. She urges them to schedule an appointment so she can examine them.
Before the outbreak, Myrick heard many concerns about vaccines, including in Gaines County's Mennonite community, where the measles first appeared in late January. At the family clinic, parents told Myrick that no one got measles anymore, so there was no need to vaccinate their children. And it only caused mild illness, they said. Others argued vaccines cause harm, despite the vaccine showing decades of safety. As their family doctor, she recommended they get the vaccine, which is safe and effective.
Such claims have helped to allow measles to return with force. Health experts cite statements made by Health and Human Services Secretary Robert F. Kennedy Jr., who previously advocated against the measles vaccine for years and has contradicted guidance from his own health agencies.
In the current outbreak, Kennedy has downplayed measles outbreaks and the severity of disease and has made incorrect statements about the current outbreak, said Dr. Richard Besser, former acting director of the CDC who is now president and CEO of the Robert Wood Johnson Foundation. A recent op-ed by Kennedy called for parents to consult with health providers about vaccination, adding the decision to vaccinate is a "personal one."
'We have conditions here that are so, so highly preventable that we're going to see come back because we have some leaders who don't believe in science,' Besser said.
Pediatricians and family doctors now should learn about diseases relegated to history, Besser added. They should ensure they know what measles, polio and different types of meningitis look like. They should also understand isolation protocols for these illnesses.
Around a fifth of unvaccinated people who get infected with measles end up hospitalized. Children who contract measles can develop pneumonia, the most common cause of death from measles, or brain inflammation that can lead to hearing loss or developmental delays. Death occurs in around 1 to 3 in 1,000 infected children.
The best defense against measles, by far, is vaccination, said Besser, a trained pediatrician. The full two-dose series, first administered around a year old, is 97% effective against measles. Just one shot provides 93% protection.
Measles is highly infectious, spreading through contact with droplets released from coughing, sneezing or talking. Measles can stay in a room or on surfaces two hours after a sick person has left. One contagious person can infect 18 others around them who aren't immunized.
A fever, cough or a rash can be a variety of different issues. But doctors can't afford to miss a measles diagnosis, said Dr. James Cutrell, an associate professor at University of Texas Southwestern Medical Center, in Dallas.
Given how contagious measles is, he said, the importance of identifying it early in order to isolate the patient, test them and confirm if it's measles is crucial to stopping the spread. Another concern is that symptoms develop typically a week or two after exposure. People can spread measles even when they're not showing symptoms.
Myrick saw this firsthand. In late January, the infected girl arrived in the emergency room with an underlying respiratory condition that put her at increased risk from the potentially deadly virus. After an emergency physician diagnosed her with measles, Myrick went to her medical texts to look up the disease to treat the girl.
She recalled the blotchy, red spots covering the girl's body from head to toe. The child was placed in isolation, with hospital staff in full gowns and masks. Through the course of the child's stay, her rash changed to smaller red dots. Myrick thought she would be the only case.
'We took every precaution we could to try to contain it and keep it isolated to just that one patient,' she said. 'And it didn't work. It didn't work at all.'
At first, the outbreak centered in the region's Mennonite community, which had been under-vaccinated with entire families infected. Myrick and staff have now seen cases among Latino infants too young to be vaccinated but facing serious illness. Pregnant women, who are at particular risk of miscarriage or premature birth from infection, are also at risk.
She expects more cases in the community. Many families call describing measles symptoms, but they won't get tested, and they won't get treatment unless infections worsen.
Outside of Gaines, the outbreak has spread in eight other counties, with exposures hundreds of miles away in and around San Antonio. Officials in New Mexico suspect their outbreak, among nine people infected, is linked to the Texas outbreak just across state lines.
Beyond Texas and New Mexico, nearby states have much lower vaccination rates than herd immunity needed to prevent outbreaks. By comparison, Texas and New Mexico had two-dose vaccination rates among kindergartners at 94.3% and 95%, respectively. But surrounding states — including Arizona, Colorado, Kansas and Oklahoma — had immunization rates below 90%, CDC data from last school year showed.
'A hope and a prayer doesn't just make it go away,' said Dr. Kisha Davis, a board member of the American Academy of Family Physicians and a health officer in Maryland. Her health department, in Montgomery County, saw one measles case a year ago in an unvaccinated person. Thanks to high immunization rates, an outbreak didn't occur, she said. 'We need to continue to be vigilant.'
In Seminole, a wooden sign read 'MEASLES TESTING' across from the local health department. In addition to testing, officials have expanded vaccination sites. More people are showing up to get vaccinated, including those that once swore off the shots, said Myrick, who recently became chief medical officer for the town's hospital. Others still don't believe in vaccines.
Myrick said her children worry about catching measles. Their classmates have contracted the disease, and her children are scared about getting a rash. Both of her children are vaccinated, she reminds them. They don't need to be afraid.
This article originally appeared on USA TODAY: Texas measles outbreak: Young doctor quickly becomes' nation's expert
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RFK Jr. fires entire 17-member CDC vaccine board. Here are the vaccines they recommended
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Critics say such a move puts ideology over science, will undermine the government's role in vaccine safety, and could lead to more deadly disease transmissions. The Advisory Committee for Immunization Practices makes recommendations on the safety, efficacy, and clinical need of vaccines to the CDC. It is comprised of medical and public health experts who develop recommendations on the use of vaccines in the civilian population of the United States. 'Today we are prioritizing the restoration of public trust above any specific pro- or anti-vaccine agenda,' Kennedy Jr., who has a history of spreading misleading and controversial claims about vaccines, said on June 9 in announcing the overhaul. 'The public must know that unbiased science — evaluated through a transparent process and insulated from conflicts of interest — guides the recommendations of our health agencies.' Dr. Bruce Scott, president of the American Medical Association, warned that Kennedy Jr's work has undermined trust and "upends a transparent process that has saved countless lives." "With an ongoing measles outbreak and routine child vaccination rates declining, this move will further fuel the spread of vaccine-preventable illnesses," he said. As of June 5, a total of 1,168 confirmed measles cases were reported by 34 jurisdictions, including a child under four in Florida, and three people have died from it. The CDC said the deaths were the first from measles in the United States since 2015. Kennedy Jr., when asked, has backed vaccination as a preventive tool during a measles outbreak but also said that vaccines should be left to parents' discretion. 'What I would say is my opinions about vaccines are irrelevant,' the health secretary said after being after being asked about the measles vaccine. 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If your CD4 count is 200 or greater, you may also need Chickenpox vaccine and MMR vaccine Liver disease: Hepatitis A vaccine, Hepatitis B vaccine, Pneumococcal vaccine Hepatitis A vaccine, Hepatitis B vaccine, Pneumococcal vaccine Lung disease (Including Asthma or COPD): Pneumococcal vaccine Pneumococcal vaccine End-stage renal (kidney) disease: Hepatitis B vaccine, Pneumococcal vaccine Hepatitis B vaccine, Pneumococcal vaccine Weakened immune system (excluding HIV infection): Hib vaccine, Pneumococcal vaccines, Meningococcal vaccines (MenACWY and MenB), Shingles vaccine What vaccines are recommended for children? 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Yahoo
24 minutes ago
- Yahoo
RFK Jr. fired all 17 members of key vaccine committee ACIP. What exactly does that mean?
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Kennedy's decision marks a reversal from what a key Republican senator said the Trump Cabinet member had promised during his confirmation hearings earlier this year. Sen. Bill Cassidy, R-Louisiana, chair of the Senate Committee on Health, Education, Labor and Pensions, said Kennedy had promised to maintain the advisory committee's current composition. "If confirmed, he will maintain the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices without changes," Cassidy said. In a June 9 post on X, Cassidy said he's in contact with Kennedy to ensure that ACIP won't "be filled up with people who know nothing about vaccines." Kennedy says "a clean sweep" will "reestablish public confidence in vaccine science," and some who follow the Make America Healthy Again movement praise his decision, but former health officials and medical experts worry the firings will sow more distrust in the public health system and impede access to vaccines. 'An important part of our social contract is trust and introducing unnecessary chaos and disruption violates that trust,' said Cathy Bradley, dean of the Colorado School of Public Health. Vaccine guidance: RFK Jr. fires entire 17-member CDC vaccine board. Here are the vaccines they recommended After the Food and Drug Administration approves a vaccine, ACIP reviews the scientific evidence to create guidance on who should receive it based on age, preexisting medical conditions and other factors. The CDC director approves these recommendations, which shape guidance from other medical organizations and insurance coverage. In an op-ed published by the Wall Street Journal, Kennedy said the committee has been 'plagued with persistent conflicts of interest,' citing evidence from 25 years ago. Brewer said the committee has since strengthened its vetting process, which typically takes a year from nomination to member status. 'All ACIP members go through a vetting for conflicts of interest,' he said. 'We're not allowed to have them during our time, we're not allowed to accept money from drug companies for consulting or grants, we're not allowed to sue them.' Members are required to disclose any conflicts of interest, which are published on the CDC website. Meetings are also open to the public, typically livestreamed on the CDC website, and are open for public comment. 'It's a very open and transparent process which leads to a body of individuals with different types of expertise,' said Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation and former acting director of the CDC. 'Pulling information from decades ago to disparage the ACIP was ludicrous.' Vaccine guidance regarding all the shots recommended for adults and children remains in place, for now, which means eligible patients should have access to these vaccines. But Dr. Tina Tan, a pediatric infectious disease physician and president of the Infectious Diseases Society of America, said that may change as Kennedy appoints new members to the advisory committee. She fears the administration could walk back certain vaccine recommendations, similar to how Kennedy dropped COVID-19 vaccine recommendations for healthy children and pregnant women on May 27. Changing vaccine recommendations could impact how private insurance companies cover certain vaccines, Tan said, which could deter Americans from getting vaccinated and fuel outbreaks of vaccine-preventable diseases. ACIP also determines which vaccines are included in the Vaccines for Children program, which provides vaccines to children whose parents or guardians may not be able to afford them. Changes made to the program would be a 'great concern for public health,' Brewer said. It's also unclear if COVID-19 vaccines will be available in the fall, he said. The committee met in April to discuss the COVID-19 shot, among other vaccines, but Kennedy canceled the vote that would have made recommendations for the fall. ACIP is scheduled to meet again between June 25 and June 27 with its new committee members, according to the HHS statement. More details: RFK Jr. fires entire CDC vaccine advisory panel Doctors and public health experts urge parents to continue discussing vaccine options with their pediatricians and primary care providers. Tan also said professional organizations such as the American Academy of Pediatrics, the American Academy of Family Physicians and the American Medical Association are working together to ensure that children have access to vaccines despite possible changes to the recommendations. She encourages parents to look to these national organizations for guidance and support, and to vaccinate their children if they're not up to date with their shots. 'They need to get up to date now, given the fact that access to vaccines at this moment shouldn't be an issue,' she said. 'The American public needs to understand that the federal agencies that were in place before… they're not going to be the same now." Adrianna Rodriguez can be reached at adrodriguez@ This article originally appeared on USA TODAY: RFK fires CDC's ACIP members: What does that mean for Americans?