Measles in West Texas, Early 2025: The First Month of an Outbreak

Measles is a highly contagious respiratory virus that can cause serious illness. On January 29, 2025, the South Plains Public Health District told the Texas Department of State Health Services (DSHS) that an unvaccinated school-aged child in Gaines County — a rural west Texas county bordering New Mexico — had measles. It was the start of an outbreak that would run until August 2025.

The first month: January 29 – February 28

Kindergarten MMR coverage in the outbreak counties in 2024–25 ranged from 77.3% to 94.6%, against 93.2% statewide.

The response

• Schools. Consistent with Texas law, health officials advised that students without documented immunity — two valid MMR doses, a documented past infection, or a positive measles antibody test — stay out of school for 21 days after an exposure. That couldn't reach children in unaccredited private schools or homeschooling, leaving room for spread.
• Information. The district and DSHS produced culturally appropriate, community-informed materials on measles and prevention for schools, nurses and parents, with clinic locations; CDC helped translate them.
• Vaccination advice for counties with ongoing spread: an early MMR dose for infants aged 6–11 months, and a second dose for adults who'd had only one.
• Clinics. 33 MMR vaccination clinics and 16 testing clinics were held — but acceptance was low, with about 275 doses given.

Why it was hard

Many people interviewed in case investigations declined to share enough to allow follow-up — names of household members (often in large households), contacts or exposures — so the chains of transmission were hard to trace, and many cases likely went unreported.

When officials reached out to trusted community members, many described a distrust of outside institutions and a reluctance to engage with public health or health care, rooted in a community ethos of independence and of finding solutions from within.

How it ended

The outbreak was declared over on August 18, 2025, after 762 confirmed cases, 99 hospitalizations and a second measles death. Its source is unknown; imported cases have started outbreaks in other close-knit, under-vaccinated U.S. communities, and falling measles vaccination worldwide raises the risk of larger outbreaks.

Lessons

• High coverage with two MMR doses is the most effective way to prevent measles.
• Partnering early with trusted community members can shape culturally appropriate materials.
• Where standard measures meet resistance, extra messaging can still limit spread and severe illness: tell people with suspected measles to stay away from others and to get medical care promptly.

Sources

Based on Crisp CA, Milton S, Lutz CS, et al., "Notes from the Field: Initial Public Health Response to a Measles Outbreak in a Close-Knit West Texas Community — January−February 2025," MMWR volume 75, number 23, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The report gives two pregnant women of 22 as 10%, which the counts don't produce, so only the counts are given here.