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This story was updated on Monday Feb. 24 at 10:30 a.m. to reflect a growing measles outbreak in Texas.
The largest measles outbreak in decades has reached San Antonio and San Marcos, according to the Texas Department of State Health Services.
Officials say an individual who tested positive for the virus in West Texas traveled to two major universities and one of the nation's busiest tourist attractions.
What is measles?
Measles is a highly contagious virus that is found in the throat and nose mucus of an infected person.
Texas Health and Human Services explained that the virus is so contagious that 90% of people close to someone infected and who are not immune will contract the virus.
The virus can live for two hours on surfaces, and it spreads from person to person through sneezes and coughs.
In fact, the virus can live in the air for two hours after an infected person sneezes or coughs.
The virus is common in childhood and adolescence, though rates fell due to the development of the measles, mumps and rubella (MMR) vaccine.
How can people protect themselves and their children?
Measles is preventable with the 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 virus is common among children, so the first dose of the vaccine is recommended around 12-15 months and the second dose at 4-6 years.
For adults, one dose is recommended for adults not at a high risk of exposure.
For those with children who are too young to receive the vaccine, they are advised to practice good hygiene like handwashing and to remind anyone in their home to do the same. They should also limit babies' exposure to crowds, disinfect surfaces and keep anyone with a cold away from young babies.
Public health experts say there are some adults who should consider getting revaccinated.
That includes older adults who were born after 1957 and were vaccinated before 1968.
That's because early versions of the measles vaccine were made from an inactivated (killed) virus, which didn't work particularly well. That's why the Centers for Disease Control and Prevention recommends that anyone vaccinated before 1968 get at least one dose of the live attenuated vaccine.
Before the first measles vaccines were developed in the 1960s, nearly everyone got the disease during childhood. So people born before 1957 are assumed to have natural immunity.
Experts say that if you're not sure of your immunity or vaccination status, there's no harm in getting a shot.
If you were vaccinated between 1968 and 1989, you likely received just one dose of the measles vaccine, instead of the two doses that are standard today. One dose alone is highly effective, and for most people, it provides more than enough protection, says Dr. Adam Ratner, a pediatric infectious disease specialist and author of Booster Shots, a book on the history of measles.
But Ratner says there are several situations in which the CDC recommends an additional dose of measles vaccine for adults who are considered at high risk. That includes people who are in college settings, work in health care, live or are in close contact with immunocompromised people, or are traveling internationally.
"If you're traveling somewhere where there's an active outbreak and you're not sure that you got two doses, it may not be crazy to get a second dose," Ratner says.
And if you live in a community which is experiencing a measles outbreak, your local or state health department may recommend a second dose for adults.
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
- Red watery eyes
- Fever of 103º or higher
A rash forms first on the face and head and moves down to the other areas of the body. The rash can last around 5-6 days and will appear after the fever sets in.
The symptoms usually set in around 8-12 days after exposure. An infected person is contagious up to four days before the rash appears and four days after the rash appears, according to the American Academy of Pediatrics.
The virus can also lead to more serious complications like pneumonia, brain swelling, deafness, and sometimes can be fatal.
What is the status in West Texas?
Measles cases in Texas have increased again this week with at least 90 confirmed cases and 16 hospitalizations.
Five of the cases were vaccinated, and the rest were not.
51 of the cases are 5–17-year-olds.
The outbreak was originally identified in Gaines County. Many of the cases are school-aged children.
Officials say an individual who tested positive for the virus in Gaines County recently traveled to San Marcos and San Antonio.
The person also was said to have been at the New Braunfels Buc-ees on Feb. 16.
Friday, February 14th:
- Texas State University in San Marcos from approximately 3 p.m. to 7 p.m.
- Twin Peaks restaurant in San Marcos from 6 p.m. to 10 p.m.
Saturday, February 15th:
- The University of Texas at San Antonio Main Campus between 10 a.m. and 2 p.m.
- San Antonio River Walk attractions— Wax Museum, Ripley’s Believe It or Not and Ripley’s Illusion Lab between 2:30 p.m. and 5:30 p.m. on Saturday, February 15th.
- Mr. Crabby's Seafood Kitchen and Bar in Live Oak between 6 p.m. and 8 p.m.
Sunday, February 16th:
- Buc-ee's in New Braunfels from 9 a.m. to noon.
Health officials say anyone at these public locations during these times or up to two hours afterward should monitor for symptoms.
"Measles is a highly contagious virus that can lead to serious complications, especially in young children and individuals with weakened immune systems. If you think you may have been exposed or are showing symptoms, please contact your healthcare provider immediately,” said Dr. Anita Kurian, Deputy Director at the San Antonio Metropolitan Health District.
Measles was declared eradicated in the United States in 2000. This was achieved through a successful vaccination program that ensured high levels of immunity in the population.
“Individuals who have not been vaccinated are at greater risk of infection. We urge everyone to ensure they are up to date on their vaccinations to protect themselves and those around them,” Dr. Kurian said.
"Protecting our community from measles starts with staying informed and taking the necessary precautions," she said. "We encourage everyone to review their vaccination status and seek medical advice if they suspect exposure. Early detection and vaccination are key to preventing the spread of this preventable disease."
NPR's Maria Godoy contributed to this report.
