Dr. Peter Hotez: Texas child’s measles death sign of large, dangerous outbreak
The news on Wednesday that a child died from measles at a Lubbock hospital is something that infectious disease experts like Dr. Peter Hotez have feared since an outbreak of the virus began spreading in northwest Texas.
The outbreak that started last month in the South Plains region has now infected 124 individuals, most of them school-aged children who have not received the vaccine that protects against measles, mumps and rubella. Measles is highly contagious and can cause severe illness, so experts like Hotez feared the outbreak could turn deadly.
“Once you get this big an epidemic, and you get numbers up in hundreds or more, it’s almost inevitable you’ll see a childhood death, and maybe more,” said Hotez, the co-director of the Center for Vaccine Development at Texas Children’s Hospital and the dean of the National School of Tropical Medicine at Baylor College of Medicine. “…It’s really sad.”
The Texas child’s death is the first measles death in the U.S. since 2015, according to the U.S. Centers for Disease Control and Prevention.
As one of the nation’s leading infectious disease experts, Hotez has been raising alarms in interviews with news outlets and on social media. He and other experts have long believed an outbreak was inevitable because a rising number of Texas parents and guardians are opting to forgo routine childhood vaccinations for measles and other infectious diseases.
The current outbreak is the state’s largest in 30 years and has already spread to neighboring New Mexico. Hotez and other experts don’t believe it will subside anytime soon, either, because measles is highly contagious. Up to nine in 10 people who are not vaccinated will become infected after being around measles, according to the CDC.
“I think these numbers will continue to accelerate for a while,” Hotez said. “So this is going to be a very large, very dangerous measles epidemic.”
Hotez spoke with the Houston Chronicle for a Q&A about measles and declining vaccination rates across Texas. The conversation has been lightly edited for brevity and clarity.
Answer: It’s the most contagious virus we know about. The only one that’s close is the later omicron strain of (COVID-19). That also had pretty high reproductive numbers, but not nearly as high as measles.
There’s two reasons why that’s the case. One is the fact that it takes a very small inoculum of virus to set up infection. You don’t need hundreds of thousands of virus particles to become infected. It only takes a few virus particles to become infected. So an average of nine out of 10 unvaccinated people who are exposed to the virus will become infected.
Reason number two is, this virus is very hearty. It stays infectious as a small particle in the atmosphere for a couple of hours, even after a person has left the room. It’s not like influenza, for instance, where you pretty much have to be in close proximity to an individual to acquire influenza …. (with measles), they can leave the room, and two hours later, there’s still infectious particles in the atmosphere.”
The difference was that in 2020 we didn’t have the COVID vaccine. We do have a (measles) vaccine, but unfortunately, we’ve got too many people in our state of Texas who are not being vaccinated, and they remain highly vulnerable.
If all the kids were vaccinated in schools, or vaccinated while being homeschooled, and the vaccination rate was 95%, this epidemic would never have occurred.
(But) the parents should not be considered the perpetrators here. The parents themselves are victims of this very aggressive and very predatory anti-vaccine lobby that we have here in the state of Texas.
The only efficient way is through a catch-up measles vaccination campaign. If your kids haven’t been vaccinated yet, now is the time to do it, and there’s two reasons. One, it will prevent you from getting infected. But even if you do get exposed to the virus, if you get vaccinated within 72 hours after exposure, it will either mitigate the symptoms or prevent you from getting the infection altogether.
The single most important thing you can do is a public relations campaign, set up as many vaccination clinics as possible, and really explain to parents the urgency of vaccinating. And also, for adults who have not gotten vaccinated.
The other is for kids – we usually vaccinate between 12 and 15 months old, and then again at 4 to 6 years of age. But you can actually get your second dose a few weeks after the first one. So if you’re in that part of Texas and you’ve only gotten a single dose, which is around 90% protective, it might be wise to go to your pediatrician to get a second dose now instead of waiting for 4 to 6 years old.
I think people should operate under the premise that measles is going to be coming, either because of the expansion of this current epidemic across the state of Texas, or because people are going to be coming in for the (Houston Livestock Show and Rodeo) and other events.
We have pockets of low vaccination in East Texas. We have pockets of low vaccination in multiple parts of the state. So I think you should plan accordingly. And planning accordingly means following the vaccination schedule, and if you’ve only gotten the single dose of the vaccine, even though the protection level lasts a long time, you may want to talk to either your primary care physician or your pediatrician about a second dose.
(Anti-vaccine) disinformation is not just random junk out there on the internet. It’s organized, it’s deliberate and it’s politically-motivated. It dominates the internet, it dominates social media, it dominates a lot of the cable news channels and it dominates a number of the podcasts. So it is pervasive.
I think the way you (combat) it is one, you try to up your game in terms of putting out correct information. That’s one step. I think the other is we need greater advocacy from our elected leaders, who need more advocacy on the importance of getting vaccinated from the celebrity community, anyone who would be recognized as an important individual.
