Last week, the Oklahoma State Department of Health sent out a health alert advising clinicians in Oklahoma to consider measles among patients with compatible symptoms amid a measles outbreak in Texas that’s now infected at least 124 people since late January.
An OSDH spokesperson told StateImpact the department is “closely monitoring the situation.”
The Texas Department of State Health Services confirmed the first death in this outbreak Wednesday. The school-aged child was not vaccinated and was hospitalized in Lubbock, Texas last week. It’s the first measles death reported in the U.S. since 2015.
Dr. Girish Murthy, an infectious disease specialist at a Mercy infectious disease clinic in Ardmore, said the outbreak in Texas is concerning.
“We're so close to Texas,” Murthy said. “So, typically, if something's going to affect Texas, we're at a high risk of getting that here as well.”
What are measles symptoms, and how does it spread?
Measles is a highly contagious disease caused by a virus, and there isn’t a specific treatment for it. Dr. Kelsey Damron, a pediatrician at a Mercy primary care clinic in Edmond, said it spreads through respiratory droplets or by coming into contact with an infected person who hasn’t washed their hands.
Patients typically develop symptoms about 10 days after exposure, Murthy said. It usually begins with a high fever – which could reach up to 103 to 104 degrees – red, watery eyes, a cough, congestion, weakness and fatigue, he said.
Three to five days after symptoms begin, infected people experience a measles rash. Murthy said people first develop flat red spots on the face which spread downward to the rest of the body. He said it can last for seven to 10 days.
An infected person can spread measles four days before to four days after this rash appears. Nine in 10 people lacking immunity to measles who come in close contact with an infected person will become infected.
Oklahoma reported one case of measles in 2024, according to an OSDH spokesperson. That case was not in the state during its incubation or infectious period despite the person being an Oklahoma resident.
“Therefore, there was no need for a robust public health investigation since no other Oklahoma individuals or settings were impacted,” the spokesperson wrote.
What can you do to protect yourself and others?
As a pediatrician, Damron said she hasn't frequently checked for measles. It was declared eliminated in the U.S. in 2000, meaning there was an absence of the continuous spread of disease for more than 12 months. The CDC states this can be attributed to “a highly effective vaccination program” in the U.S., as well as “better measles control in the Americas region.”
Now, Damron said she might be on the lookout for it more in the future as more people choose not to vaccinate their kids.
The CDC notes vaccine exemptions above 5% can increase the risk of outbreaks of preventable diseases. During the 2023-24 school year, the CDC reported Oklahoma kindergartners’ vaccine exemption rate rose to 5.7%. Oklahoma kindergarteners had an 88.3% vaccination rate against measles, meaning they received two doses of the measles, mumps and rubella (MMR) vaccine.
“With how contagious measles is, I would worry that children who have very high fevers, they're dehydrated, they're having the rash – all these symptoms – that it will overwhelm the health care system if we are not prepared for it, if people are not vaccinating,” Damron said. “I think it could be a real situation.”
Two doses of MMR vaccine are 97% effective at preventing measles, and one dose is 93% effective, according to the CDC. The agency states that breakthrough infections can occur, especially in communities experiencing an outbreak where high levels of measles virus are circulating.
The CDC states measles can be serious among all age groups, but those who are more likely to suffer from complications include:
- Children younger than 5 years old
- Adults older than 20 years old
- Pregnant women
- People with weakened immune systems, such as from leukemia or HIV
Those complications could involve hospitalization, pneumonia, brain swelling, complications during pregnancy or death, according to the CDC.
“Typically, with the vaccine, the main issue is going to be some soreness [of] the arm for a day … from the injection itself, but otherwise it's a benign vaccine, easy to tolerate, and the best way to prevent [measles] is to get the vaccine,” Murthy said.
Those concerned about their immunity or worried they might come into contact with someone who’s infected can get their immunity levels checked with their primary doctor, Murthy said.
An OSDH spokesperson said measles is a reportable condition in Oklahoma, and clinicians are advised to report measles cases immediately upon suspicion to the OSDH epidemiologist-on-call to ensure a timely public health response.
“Unfortunately, if you feel you've been infected with measles, it's not the best thing to … go to the office, where you have to run the risk of exposing someone else,” Murthy said. “So call the office, they'll give you some guidance. But the main thing is to stay hydrated, drink lots of fluids [and] control the fever.”
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