'Thousands' possibly exposed to measles in Texas as outbreak grows
The West Texas measles outbreak continues to grow, now possibly spreading into the central part of the state and neighboring New Mexico, health officials said Friday.
The Texas Department of State Health Services confirmed there have been 146 cases of the highly contagious virus since the outbreak, centered in Gaines County, began in late January. Twenty people have been hospitalized and one child has died.
Parts of Central Texas have been monitoring for measles cases ever since an infected person traveled from Gaines County to San Marcos and San Antonio over Valentine's Day weekend.
The person visited the University of Texas at San Antonio campus and a variety of restaurants and convenience stores like Buc-ee's in other areas near the city.
'It's very possible that this person could have come in contact with, if not hundreds, thousands of our community residents, as well as visitors,' Anita Kurian, San Antonio Metropolitan Health District Deputy Director of Communicable Disease, said at a media briefing Friday. 'We are a destination city. We have real great concern of potential large community wide exposures at these public sites.'
In a separate briefing Friday, Katherine Wells, director of public health for Lubbock's health department, said most of the community is vaccinated, although because measles is so contagious, they are reaching out to families and closely monitoring schools for more infections.
'I do expect to see additional cases,' she said. 'I'm very nervous about getting a measles case in a school or a day care. We are closely monitoring that.'
Dr. Ronald Cook, chief health officer at both the Texas Tech University Health Sciences Center in Lubbock and the city's Health Authority, cautioned that people may not know if they've been exposed. The incubation period is seven to 14 days. The earliest symptoms are a cough, a runny nose and conjunctivitis, or red, watery eyes, followed by sore spots in the mouth and a high fever of 103-104 degrees. A rash typically begins on the scalp or face and works its way down the body, he said.
People are infectious 'from four days before the rash appears until four days after the rash,' said Cook. 'Then it's another 10 days to get over the disease.'
Kurian said her office is getting up to 80 calls a day from people who are concerned about their exposure to measles in San Antonio. It could be at least a week until cases reveal themselves.
'We expect to see any cases coming out of these exposures by March 8,' she said.
Most or all of the hospitalized patients have been children. Kids who have been admitted are either extremely dehydrated or are having serious trouble breathing, Cook said during the briefing Friday.
Small children have tiny airways that can't easily handle the massive amounts of inflammation caused by measles, he said.
Most of the cases are unvaccinated children, including a school-age child who died on Wednesday.
Health officials are also trying to figure out if nine measles cases in neighboring New Mexico, announced previously, are linked to the Texas outbreak.
Cases unrelated to the current outbreak have also popped up in Alaska, California, Georgia, Kentucky, New Jersey, New Mexico, New York City and Rhode Island.
The origin of the West Texas outbreak, which is believed to have started within a close-knit Mennonite community, is unknown, Wells said Friday.
'We're not going to have an answer anytime soon,' she said, noting that other outbreaks in recent years have come from 'a U.S. citizen or someone traveling out of the country and bringing it back in.'
While measles is one of the most contagious viruses in the world, it's controlled by widespread use of the measles-mumps-rubella vaccine (MMR) in a population. Two doses of the shot are 97% effective in preventing the disease, and the vast majority of U.S. kids get them as the CDC has long recommended: one dose around age 1, and another around age 5.
As vaccine hesitancy has increased over time, fewer kids are getting their shots. The vaccine exemption rate in Gaines County was nearly 18% for the 2023-24 school year, according to health department data.
There are no vaccine mandates or forced quarantines in the communities affected by the current measles outbreak. There is, however, free testing and vaccinations being offered.
'We learned lots of lessons during Covid,' Cook said. 'We can't force anybody to take a drug. That's assault.'
Cook said he expects the outbreak will grow in the coming weeks.
'It's not a huge wildfire,' he said. 'It's going to be a smoldering fire, a tumbleweed fire, for a while until we finally get it stopped and put out.'
Late Thursday, the Centers for Disease Control and Prevention posted its first public statement about the outbreak. According to the CDC, the Department of Health and Human Services is 'providing technical assistance, laboratory support, vaccines, and therapeutic medication as needed to the Texas Department of State and Health Services.'
The CDC said that vaccination 'remains the best defense against measles infection.' Early in the outbreak, state health authorities in Texas asked for 2,000 extra doses of the MMR vaccine, which were provided by the CDC.
There is no specific treatment or antiviral drug for measles. Doctors mainly try to keep patients hydrated and help them get enough oxygen.
This article was originally published on NBCNews.com
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Patricia Cook was a sports fanatic, and Cook did his best to keep up with NASCAR, golf, tennis, and his wife's lifelong passion, the Green Bay Packers. His wife was larger than him, Cook said, and he dropped her a couple of times while helping her to the bathroom. There were several trips to the hospital, a two-week stay in the ICU and two sepsis scares. "This all got to feel normal," he said. Toward the end, he said he had to call 911 every time his wife needed to use the bathroom because he couldn't safely bring her there himself. He knows that's "not what they're designed to do," but he said the paramedics were nice about it. 'Most men in Dave's position, they would have checked out a long time ago," Ruh said. "They would have left. Dave is kind of an exception. There are exceptional men out there, and Dave is one of them.' The last time his wife was at the hospital, he watched three nurses struggle to get her onto a bedpan. That's when Patricia Cook decided she was ready to go into hospice. 'I thought, 'How is one 68-year-old man with a bad back going to handle this?' But I never challenged it," Cook said. "I said, 'OK. That's what you want, that's what we'll do.'" When they got home, Cook said the hospice company didn't explain anything to him. He didn't know how to distribute her pain medication and said his wife refused to use the hospital bed that they brought in. That's when Ruh, who has personal and professional caregiving experience, came to help. She said none of the equipment the company provided was useful for Patricia Cook's situation. 'It was a mess," Ruh said. "Poor Dave, I felt bad for him.' Ruh found a different hospice company for the Cooks and stopped by daily to check on them. When Cook had to leave to pick up food or new prescriptions, Ruh kept his wife company. Ruh knows that hospice is meant for end of life care, to keep a patient comfortable and happy so they can die peacefully. But she doesn't think Cook had fully accepted his wife was about to die. 'Honestly, I think they were both still in denial," she said. Cook was fed up and irritated by the first hospice company, and Ruh said he was afraid of the pain medications. That's common, she said. Family caregivers stress about how much to give a patient, and worry that they are aiding in their loved one's death if they give too much medicine. Patricia Cook was in hospice for nine days. She slipped into a coma after six of those days. Cook administered morphine for her every hour or so. He said he was afraid to go to sleep and miss a dosage. He started seeing double. He sat with her in the living room, listening as her snores progressed to a death rattle. 'To listen to that for three days and knowing there's nothing you can do," he said. "It was just awful.' Then, on Saturday, Dec. 14, the sounds ceased. Cook called the hospice company and the funeral home, and waited an hour and a half for his wife to be taken away. Recovering caregiver asks, 'Now what?' Cook said he lost 40 pounds in about a month because of the stress of caregiving. He stopped getting his hair cut or seeing his own doctor. He went four days without a shower. 'I was just so wiped out, and so mentally spent," he said. After his wife died, "I just wanted to sit in a chair and just kind of contemplate all this.' "All of a sudden, boom, it's over," Cook said. "Now what do you do?' The Cooks never had children. Cook's two brothers died years ago. Now, he said, he feels "really alone." He doesn't like being in his home anymore, the place he's lived for nearly two decades. He considered going back to work, but he's not sure that makes sense, either. 'What I'm going through now is far harder than taking care of her," he said. "When I was taking care of her, especially the last few months, I was so busy with all of this that I didn't have time to think about me.' Loneliness and a sense of uncertainty about the future are some of the most common reactions caregivers have after the person they cared for dies, Irving said. Caregivers might feel guilt, too, especially if they think their loved one was in pain before they died. Relief is common, too, Irving said − relief that their caregiving duties are over, or relief that their loved one isn't suffering anymore, or both. 'For many caregivers, they have put aside so many aspects of their life before caregiving that it's hard to know how to restart," Irving said. Soon after his wife died, Cook started a 13-week GriefShare program at his church. The support group met weekly to discuss common struggles people face while grieving. Jeff Forrey, a senior curriculum writer for Church Initiative, a nondenominational, nonprofit ministry that develops programs like GriefShare to help people in crisis, said more than one million people have been through the program. In GriefShare, Forrey said, participants get to know one another and encourage each other while going through videos, articles, exercises and bible studies. They talk about normal reactions to grief, like anxiety, anger, loneliness, identity issues and regrets. They also talk through what the future looks like without the person they love and how relationships with other friends and family members might change, too. 'It allows them to see the wide variety of possible reactions that are a part of normal grief," Forrey said. Cook found comfort in the program, where he said he was the only man among nearly 20 grieving women. He said talking about his experience caring for and then losing his wife was helpful as he tried to process all he's been through. 'You get to know these people," he said. "I was sorry to see it end.' Since then, Cook has had a couple of virtual therapy sessions. He'd rather see a therapist in person, but he said the wait to get an in-person appointment is at least six months. 'I'm a glass-half-full kind of person. I have faith that everything will be better again," Cook said. He laughs remembering how his wife, in her final weeks, encouraged him to date again after she died. She told him women will be "beating down the door for you." "'But don't you get married, or I'll haunt you,'" he said she told him. His dog Bucky still sleeps by Cook's heart, as he always has. But everything else in his life, Cook said, "is never going to be the same.' He doesn't regret any moment he spent caring for his wife. When you love someone, he said, it's what you do. "As tough as it is, it's worth it,' he said. 'I wouldn't have wanted it any other way.' Madeline Mitchell's role covering women and the caregiving economy at USA TODAY is supported by a partnership with Pivotal Ventures and Journalism Funding Partners. Funders do not provide editorial input. Reach Madeline at memitchell@ and @maddiemitch_ on X.
