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State medical experts have confirmed 124 cases of measles in Texas. This is the largest measles outbreak in Texas in 30 years.
Here is how it started and an overview of the situation, as of Feb. 25.
A new year begins with a health alert
The outbreak originated in Gaines County, a small West Texas county, in January. A health alert was issued by the Texas Department of Health and Human Services (HHS) on Jan. 23. Two school-age children tested positive and were hospitalized and discharged by the time the alert was released.
But the first confirmed cases of measles in 2025 were detected in Harris County, according to HHS. These two people lived in the same household and had traveled internationally in recent days. They were both unvaccinated.
These cases were not associated with the outbreak, but they were the first cases in Texas since 2023.
By the end of January and first week of February, 10 cases were confirmed in Gaines County, and an alert of an outbreak was issued. All were cases of unvaccinated people, including many school-age children.
Cases spread across counties, and health officials go on alert
Over the next few weeks, more cases were confirmed in and around Gaines County.
By Valentine's Day, 50 cases were confirmed, and the next week saw 90 cases.
HHS releases updated numbers of cases every Tuesday and Friday.
Further exposure
An alert on exposures in Central Texas was issued after an individual who visited San Marcos, New Braunfels and San Antonio tested positive for the virus.
The person who tested positive visited major tourist destinations and highly populated areas of the cities, including the University of Texas at San Antonio, the Buc-ees store in New Braunfels, Texas State University and San Antonio's River Walk.
On Tuesday, Feb. 25, HHS, issued this statement: "The Texas Department of State Health Services is reporting an outbreak of measles in the South Plains region of Texas. At this time, 124 cases have been identified since late January. Eighteen of the patients have been hospitalized. Five of the cases are vaccinated. The rest are unvaccinated, or their vaccination status is unknown. Due to the highly contagious nature of this disease, additional cases are likely to occur in the outbreak area and the surrounding communities. DSHS is working with local health departments to investigate the outbreak."
Anita Kurian, the deputy director of San Antonio's Metropolitan Health District, said the first thing concerned people should do is check their vaccination status.
"If you think you've been potentially exposed, regardless of your vaccination status, go ahead and start self-monitoring yourself for symptoms," Kurian said. "You should monitor this for at least 21 days from your date of last exposure .... it's very important — do not show up in your doctor's office or any other health care facility unannounced because you will be putting the medical staff and other patients at risk."
Who should be vaccinated?
Those who are unsure of their vaccination status can contact the Texas Department of State Health Services or call Metro Health and request records.
Measles is preventable with the measles, mumps and rubella (MMR) vaccine. The American Academy of Pediatrics explained that about 95 of every 100 people vaccinated with one dose are protected, and 97-99 out of 100 are protected with two doses.
The first dose is administered at 12 to 15 months, and the second dose comes later once the child reaches school age.
Older adults who were born after 1957 and vaccinated before 1968 should consider revaccination. During this time frame, an inactive or killed virus was administered and proved to be ineffective.
The Centers for Disease Control and Prevention (CDC) recommends at least one dose for those adults who may have received the inactive virus.
Risks for pregnant women?
Pregnant women cannot receive the vaccine because it is a living virus and can cause bad birth outcomes, Kurian explained.
The CDC advised women who are planning to become pregnant to check if they are vaccinated beforehand or get the vaccine before.
Contracting the virus during pregnancy could lead to severe birth defects, the CDC explained.
Risks for disabled and immunocompromised people?
Dr. Jason Bowling, an infectious disease specialist at UT Health San Antonio, advised exposed caretakers to be mindful if they are the only people taking care of an immunocompromised person.
"They should avoid sharing utensils, drinking glasses," he explained, "They should use hand hygiene frequently, and they should also be cleaning environmental surfaces frequently, as well as much separation as they can do. They should implement that until they're past the time period of being a more transmissible risk."
Bowling added that immunocompromised people are one of the highest at risk for catching measles and other severe illnesses.
Outbreaks in the past
Bowling added that the disease was believed to have been eradicated in 2001 but some outbreaks have occurred since.
"[Outbreaks] tend to happen in areas where there's high densities of people that are unvaccinated. In areas where there's more vaccinated people, we tend not to see ongoing outbreaks," he said. "So we still have high vaccination rate uptake rate overall in Bexar County."
What are the signs and symptoms?
For those concerned that their child may have contracted measles, they can look for these symptoms:
- Cough
- Runny nose
- Tiny white spots that may appear inside the mouth around two to three days after symptoms set in.
- Red watery eyes
- Fever of 103 degrees or higher
A rash forms first on the face and head and then moves down to the other areas of the body. The rash can last around five to six days and will appear after the fever sets in.
The symptoms usually set in around eight to 12 days after exposure. An infected person is contagious up to four days before the rash appears and four days after the rash appears, the American Academy of Pediatrics explained.
The virus can also lead to more serious complications like pneumonia, brain swelling, deafness, and it sometimes can be fatal.
Metro Health officials said they will offer pop up vaccinations locations if needed, a service offered since before the outbreak. They have also begun educational outreach too.
Jackie Velez contributed to this report.
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