Who Was Hospitalized in the 2025 West Texas Measles Outbreak

Measles is a highly contagious, vaccine-preventable virus that causes fever and rash and can lead to serious complications, especially in children under 5. The United States declared measles eliminated in 2000, but long outbreaks keep happening when the virus is brought in from abroad and spreads in communities with low vaccination coverage.

On January 29, 2025, the South Plains Public Health District alerted the Texas Department of State Health Services (DSHS) to measles in an unvaccinated school-aged child in Gaines County. From January 20 to March 18, 2025 — while CDC was helping Texas respond — 325 confirmed cases were reported in the South Plains region of west Texas, and 60 (18.5%) patients were hospitalized. This report looks at the 54 hospitalized patients whose medical records were available.

Measles cases by date of rash onset, showing which patients were hospitalized. Credit: Centers for Disease Control and Prevention.

Who was hospitalized

• All 54 were unvaccinated or had unknown vaccination status.
• 49 (90.7%) were under 18: 30 aged 0–4 and 19 aged 5–17.
• 34 (63.0%) were female.
• 48 (88.9%) had no underlying medical conditions; none was severely immunocompromised.
• Besides fever and rash, most had cough (94.4%), runny nose (77.8%) or conjunctivitis (59.3%).

How sick they were

Patients were admitted a median of 2 days after the rash appeared and stayed a median of 2 days (up to 20). Every one had a clinical reason to be in hospital — no one was admitted just for isolation.

A second child died of measles after March 18, outside this report's period.

Co-infections affected 17 patients (31.5%), including Mycoplasma pneumoniae (5), influenza (4), RSV (3) and group A strep (3), and may have added to severity. 28 patients received antibiotics, most often for pneumonia, ear infections or sore throat. 13 children received vitamin A, and 2 infants under 3 months old received immune globulin.

Pregnant women and newborns

Four of the five hospitalized adults aged 18–44 were pregnant, all in the third trimester (34–40 weeks). None developed pneumonia or low oxygen. Two gave birth in hospital, and both newborns tested positive for measles within 2 days of birth; one later developed symptoms consistent with measles meningoencephalitis and was hospitalized again weeks later.

The whole outbreak

The outbreak was declared over on August 18, 2025, 42 days after the last case's rash began, with 762 confirmed cases, 99 hospitalizations and two deaths. Later in the outbreak, more adults were infected (32.4% of all cases, compared with 9.2% in these early months) and some vaccinated people had breakthrough infections (5.8% of all cases, compared with none early on).

Across the early months, about 1 in 5 patients needed hospital care — similar to past outbreaks — and the complications matched those seen before.

Limitations

• People infected in the region may have been treated elsewhere, so hospitalizations may be undercounted — while mild cases were probably undercounted too, which would overstate the hospitalization rate.
• Not all records were available, so complications, co-infections and treatments may be underestimated.
• The Texas Immunization Registry is opt-in, so some vaccine doses may not have been verifiable.

Prevention

Vaccination on the recommended schedule, and following public health guidance during outbreaks, is the most effective way to prevent measles and its severe complications. One dose of measles vaccine is about 93% effective; two doses are 97% effective, and cases in vaccinated people are usually mild. Community coverage above 95% is needed for herd immunity. Clinicians treating measles should be ready to test for and manage complications and co-infections.

Sources

Based on Wang D, Rogers CC, Lutz CS, et al., "Characteristics of Patients Hospitalized with Measles During an Outbreak — West Texas, January–March 2025," Morbidity and Mortality Weekly Report 75(20), Centers for Disease Control and Prevention; a work of the United States government in the public domain. Original report.