Measles cases surge in 2025, raising fears of widespread outbreak

A second child with measles has died in Texas, state officials said on Sunday, in an outbreak of the childhood disease that has resulted in nearly 500 cases in Texas and has spread across 22 states.

The unvaccinated school-aged child, who had no underlying health conditions, died on Thursday in the hospital from measles pulmonary failure, the Texas Department of State Health Services said.

“The child was receiving treatment for complications of measles while hospitalized,” Aaron Davis, a spokesperson for UMC Health System in Lubbock, Texas, said in an email.

It is the second death of a child in Texas since the measles outbreak began in late Januaryin Gaines County, where the vaccination rate is about 82%, below the 95% considered protective for those who cannot be vaccinated.

When asked about the measles death, U.S. President Donald Trump told reporters on Air Force One that if the outbreak progresses his administration will “have to take action very strongly.”

Health and Human Services Secretary Robert F. Kennedy Jr., in a post on X, identified the child as 8-year-old Daisy Hildebrand and said he visited Texas on Sunday to comfort the family.

Kennedy, an anti-vaccine advocatewho has declared that vaccination is a personal choice, said on Sunday vaccines are the best protection against measles.

Explainer: Measles

WHY WORRY ABOUT MEASLES NOW?

There have been more US measles cases in the first months of 2025 than in all of 2024. In addition to the outbreak in West Texas and New Mexico, the U.S. has reported 607 cases as of April 3, including 124 in the previous week.

In Europe, 127,350 cases were reported in 2024, double the number in 2023 and the highest in 25 years, according to the World Health Organization and UNICEF, the United Nations children’s organization.

In the decade before a vaccine became available in 1963, there were 3 to 4 million US measles cases each year – mostly in children – with 48,000 hospitalizations and 400 to 500 deaths.

Complications from measles include ear infections, hearing loss, pneumonia, croup, diarrhea, blindness and swelling of the brain. Even in healthy children, measles can cause serious illness and death. In unvaccinated pregnant women, measles may cause premature birth or a low-birthweight baby.

The U.S. Centers for Disease Control and Prevention estimates that about 1 in 5 unvaccinated people in the U.S. who get measles will need hospitalization.

HOW ARE MEASLES INFECTIONS PREVENTED?

The best protection is the vaccine, either given alone or as part of a Measles-Mumps-Rubella shot commonly known as the MMR vaccine or a Measles-Mumps-Rubella-Varicella (MMRV) vaccine. No vitamins or drugs have been shown to prevent measles.

Two doses of the MMR vaccine provide 97% protection against the virus. Children typically first receive the vaccine when they are 12 to 15 months old and again at age 4 to 6 years.

Adults born before 1957 are presumed to have acquired immunity as they most likely had measles during childhood.

Adults who do not remember having measles and don’t know whether they were vaccinated should get a dose of the vaccine, the CDC says. The agency also advises a booster dose for adults who received boosters many years ago who might be exposed to an outbreak.

HOW ARE MEASLES OUTBREAKS PREVENTED?

At least 95% of kindergarten-age children need to have received the measles vaccine to achieve so-called herd immunity that can prevent outbreaks.

That goal has become elusive in recent years as public figures have promoted theories – contrary to scientific evidence – that childhood vaccines are a cause of autism and other health risks. Robert F. Kennedy, Jr., who heads the U.S. Department of Health and Human Services, has helped sow such doubts for decades.

The idea stems from a long since-debunked study of 12 children led by British researcher Andrew Wakefield in the late 1990s that connected autism to the measles vaccine. No rigorous studies have found links between autism and vaccines or medications, or their components such as thimerosal or formaldehyde.

Vaccination coverage among US kindergartners decreased from 95.2% during the 2019–2020 school year to 92.7% in 2023–2024, according to the CDC.

The Texas county at the center of the current outbreak had an 80% vaccination rate among kindergarten children in 2023-24. Vaccination rates below what is needed to reach herd immunity leave those who cannot receive the vaccine unprotected and vulnerable to the virus, including young infants and individuals with immune disorders.

HOW DOES MEASLES SPREAD?

Measles spreads via respiratory droplets produced by coughing or sneezing. Virus particles can remain suspended in the air for up to two hours. If one person has measles, up to 90% of unvaccinated people nearby will become infected, the CDC says.

Symptoms including cough, runny nose, inflamed eyes, sore throat, fever, and the telltale red, blotchy skin rash don’t appear until 10 to 21 days after exposure. Because infected people can unknowingly spread the disease to others during that time, health experts advise a 21-day quarantine for unvaccinated individuals who have been exposed to measles.

HOW IS MEASLES TREATED?

There are no specific drugs for measles. Treatments can only help to ease symptoms and limit complications. The WHO recommends rest, keeping hydrated with fluids, and using fever reducers such as ibuprofen or acetaminophen.

Antibiotics can be used to treat pneumonia and ear and eye infections due to measles. Steroids have been used to treat a rare complication of measles that causes brain swelling, but steroids also weaken the immune system’s defense against the virus.

CAN VITAMIN A PREVENT OR TREAT MEASLES?

Vitamin A supplements, which have been raised by Kennedy as a vaccine alternative, cannot prevent measles. Studies show high doses of vitamin A can dramatically reduce severe complications in children with measles, based on research in low-income countries where malnutrition is common.

Any evidence in favor of giving vitamin A to measles patients in the developed world “is weak at best,” said Dr. Sean O’Leary, chair of the Infectious Diseases Committee of the American Academy of Pediatrics (AAP).

WHO and AAP warn that vitamin A in doses recommended for measles must be given under a doctor’s supervision because of the risk of toxicity.

“The most effective way to prevent the spread of measles is the MMR vaccine,” he said in the post on X. He said that as of Sunday there were 642 confirmed cases of measles, 499 of those in Texas.

Kennedy has previously also recommended Vitamin A as a measles treatment, along with good nutrition. While Vitamin A has been shown in some studies in developing countries to lessen the severity of symptoms, it can lead to liver toxicity in high quantities.

Republican U.S. Senator Bill Cassidy, a physician who chairs the Senate health committee, wrote on X after the child’s death was disclosed: “Everyone should be vaccinated.”

“Top health officials should say so unequivocally b/4 another child dies,” Cassidy wrote on X.

Cassidy had backed Kennedy’s confirmation after Kennedy promised not to make changes to vaccine oversight.

The measles vaccine is 97% effective after two shots.

He said teams from the U.S. Centers for Disease Control and Prevention have been redeployed to Texas at the request of the state’s governor, Greg Abbott.

The CDC on its website says the vaccine is “the best protection against measles,” which spreads through the air when an infected person sneezes or coughs.

KENNEDY HEARING POSTPONED

Cassidy last week called for Kennedy to appear before the Senate health committee on April 10 to discuss the U.S. health department’s restructuring in which 10,000 people were being laid off, including from the Food and Drug Administration and the Centers for Disease Control and Prevention.

But on Friday a committee official said the hearing would not occur on April 10 because seven days’ notice had not been given as required by committee procedure. No date has been set.

The Texas Department of State Health Services reportedon Friday 59 new measles cases in three days, a 15% jump, for a total of 481 in the state since late January.

Related measles outbreaks have been reported in other states, including New Mexico and Oklahoma. In addition, an unvaccinated New Mexico adult tested positive for measles after dying in March.

As of Thursday, the Centers for Disease Control and Prevention reported a weekly nationwide increase of 124 measles cases, bringing the total to 607 so far this year. That compares to a nationwide total in 2024 of 285 reported cases.

CDC officials said 97% of U.S. cases are unvaccinated or have an unknown vaccination status.

Pediatricians and other doctors are pushing back against vaccine hesitancy and warning parents that vitamin A and other supplements touted by vaccine critics will not protect their children from the highly contagious and potentially fatal disease.