Measles Outbreak Reaches 208 Confirmed Cases Across Texas and New Mexico

Measles Outbreak Update: Clinical Guidance and Vaccination Protocols

Outbreak Statistics and Geographic Spread

The current measles surge is concentrated primarily in the Southwest. According to the CDC, Texas and New Mexico account for the vast majority of cases in the United States this year. By March 7, 2025, officials confirmed 198 cases in Texas and 10 in New Mexico, including one fatality in each state. The outbreak has been characterized by rapid expansion, with health authorities warning that more cases are expected as this outbreak continues to expand rapidly.

While the focus is on the Southwest, the viral illness has appeared across a broader geography. As of March 6, 2025, a total of 222 cases were reported across twelve U.S. jurisdictions: Alaska, California, Florida, Georgia, Kentucky, New Jersey, New Mexico, New York City, Pennsylvania, Rhode Island, Texas, and Washington. Of these, 201 cases occurred in New Mexico and Texas. Data indicates that 93% of the 2025 cases are outbreak-associated, with an outbreak defined as three or more related cases. This represents a shift in transmission patterns compared to 2024, when 16 outbreaks were reported and 69% of cases were outbreak-associated.

Clinical Guidance and Vaccination Protocols

The Measles Collaborative is working to provide updated guidance for clinicians as they face the challenge of identifying and treating the highly contagious virus. The CDC emphasizes that the Measles-Mumps-Rubella (MMR) vaccine remains the most important tool for preventing measles. Most of the 222 cases reported in 2025 are among children who had not received the MMR vaccine.

Healthcare professionals are advised to ensure patients are up to date on their immunizations per routine Advisory Committee on Immunization Practices (ACIP) recommendations, particularly those planning international travel. The routine schedule for children involves two doses: the first at 12–15 months and the second at 4–6 years before school entry. For adults not at high risk, the recommendation is at least one documented dose or other evidence of immunity, such as positive measles immunoglobulin G (IgG). Adults at high exposure risk—including students at post-secondary institutions, healthcare workers, and international travelers—should have two documented doses.

Specific vaccination protocols include:

• Infants 6–11 months: May receive an early dose if traveling internationally or in outbreak settings. MMR is not licensed for children under 6 months of age.
• Unvaccinated children older than 12 months: Recommended to receive one dose immediately, followed by a second dose at least 28 days after the first.
• Texas-specific guidance: The Texas Department of State Health Services (DSHS) has recommended that infants 6 through 11 months in affected counties receive an early dose, with subsequent doses following the standard childhood schedule. Teenagers and adults previously vaccinated with one dose should receive a second dose, and those with no evidence of immunity should receive one dose immediately followed by a second at least 28 days later.

Transmission Risks and Symptom Recognition

Measles is a highly contagious viral illness that spreads through direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes. The virus can remain infectious in the air and on surfaces for up to 2 hours after an infected person has left an area. Clinicians are encouraged to remain vigilant for patients presenting with febrile rash illness that meets the measles case definition.

The typical progression of the illness begins with a 2-to-4-day period of fever, cough, coryza (runny nose), and conjunctivitis (pink eye) before the onset of a rash. The incubation period from exposure to fever is usually about 7–10 days, and from exposure to rash onset is usually about 10–14 days, with a range of 7 to 21 days. Infected individuals are considered contagious from four days before the rash appears until four days afterward. Because of the potential for severe complications, such as pneumonia and encephalitis (inflammation of the brain), early detection and reporting remain critical for public health monitoring.

Readers should consult a qualified healthcare professional regarding personal vaccination status or medical concerns.