Texas Among Most Vulnerable To Measles Outbreak

AUSTIN, TX — Four Texas counties are among the top 25 in the nation identified as being most at risk for a measles outbreak, according to a new study.

The findings by researchers at the University of Texas at Austin and John Hopkins University were published this week in The Lancet. Compiled data show Travis, Bexar, Harris and Tarrant counties are among the most vulnerable for an outbreak against a backdrop of increased cases.

Since January 2019, there have been more than 700 confirmed measles cases in 22 states — nearly double the amount of last year and the highest number reported since the virus supposedly was eradicated in the United States in 2000, according to the study. Twenty-five counties across the country have been identified to be most at risk for a measles outbreak due to low vaccination rates compounded by a high volume of international travel, according to the study.

Only Florida (with five counties on the list) exceeded Texas in terms of risk level. Among the Texas counties, Harris County ranked 9th in the high-risk list while Tarrant County came in 12th. Travis and Bexar counties were ranked 22nd and 33rd, respectively. Researchers singled out Travis County as being among the most at-risk areas that have yet to report a case located near an international airport (Austin-Bergstrom International Airport), suggesting the potential for wider exposure due to travel.

In identifying the 25 counties most vulnerable for en masse infection, analysts considered an area’s volume of international travel from foreign countries with large measles outbreaks and the prevalence of non-medical exemptions from childhood vaccinations.

“For measles, most experts believe that there will be one to two deaths per 1,000 cases, most likely infants," explained the study’s lead author, Sahotra Sarkar, a philosophy and integrative biology professor at UT Austin and an expert on public health. "We are set to see over 1,000 cases in the U.S. in 2019. So, for the first time since the 1980s, we may expect infant deaths from measles in the U.S."

Sarkar stressed the key role travel plays in broadening the scourge: “We have long known that vaccine avoidance is a critical public health issue in the U.S. and Europe. Our results show how travel from regions elsewhere compounds this risk.”

Sarkar and his team’s measles risk analysis correctly predicted areas in Washington, Oregon and New York that are already experiencing major outbreaks, university officials noted. Furthermore, officials said, 30 of the 45 counties that have reported measles cases to the Centers for Disease Control and Prevention were either included on the researchers’ list of 25 high-risk counties or are adjacent to a county listed.

Lauren Gardner, an associate professor of civil engineering at Johns Hopkins and a UT Austin engineering alumna, voiced recommendations to prevent an outbreak at the county level: "Critically, we recommend that public health officials and policymakers prioritize monitoring the counties we identify to be at high risk that have not yet reported cases, especially those that lie adjacent to counties with ongoing outbreaks and those that house large international airports,” she said.

As if the results weren't sobering enough, researchers noted the potential for disease outbreak isn't limited to measles: “The vaccine avoidance problem is not limited to measles. Pertussis — whooping cough — is another disease making a comeback because of dropping vaccination rates, and we predict serious outbreaks in the U.S. in the near future,” Sarkar said. “Policymakers must focus on centers of vaccination refusal as well as regions with a lot of passenger inflow from affected countries worldwide if there are even small local pockets of unvaccinated people.”

Texas has emerged as something of a potential measles ground zero in the past. Last summer, the Texas State Health Department said up to 57,000 children had parents opting out of childhood vaccinations ahead of the school year. Those state figures came on the heels of a Public Library of Science's PLOS Medicine medical journal study showing Austin, Fort Worth, Houston and Plano as being among the cities where more than 400 kindergarten-aged children weren't vaccinated.

The issue is particularly polarizing in Texas, where conservative lawmakers casting a suspicious eye on scientific data sometimes posit vaccinations as bad. Given that thinking, the Texas House in 2017 passed a bill preventing newly placed foster children from being vaccinated. "Immunizations do not qualify as emergency care," state Rep. Bill Zedler, a Republican from Arlington, said at the time. "No vaccine cures a disease." In championing the immunization block, Zedler was joined by several Republican members of the so-called "Freedom Caucus" sharing his view framing vaccines as invasive and unnecessary.

While not mentioned in The Lancet study, much of the blame for increased measles cases has its roots in a long-discredited study erroneously linking vaccinations to autism. The 20-year-old study was broadly discredited before it was retracted from the publication that first disseminated it, but science skeptics continue to give it currency.

Not helping preventive action thwarting disease via vaccinations is the long list of high-profile celebrities — Jim Carrey, Jenny McCarthy, Jenna Elfman, Alicia Silverstone, Charlie Sheen, Kirstie Alley and others — promoting the widely debunked vaccinations-autism link. Closer to home in nearby San Antonio, former Bexar County District Attorney Nico LaHood publicly launched an anti-vaccination crusade on his official Facebook page where he advocated for parents' rights in deciding not to immunize their children against infectious diseases.

Related stories:

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Texas House Passes Bill Banning Mandatory Vaccination Of Children In Foster Care

According to the report, the nation's 25 counties at greatest risk for a measles outbreak (in descending order) are:

• Cook County, Illinois.
• Los Angeles, California.
• Miami-Dade, Florida.
• Queens, New York.
• King, Washington.
• Maricopa, Arizona.
• Broward, Florida.
• Clark, Nevada.
• Harris, Texas.
• Honolulu, Hawaii.
• Wayne, Michigan.
• Tarrant, Texas.
• Multnomah, Oregon.
• Orange, Florida.
• Essex, New Jersey.
• Denver, Colorado.
• Hillsborough, Florida.
• San Mateo, California.
• Salt Lake, Utah.
• Suffolk, Massachusetts.
• Clayton, Georgia.
• Travis, Texas.
• Hennepin, Minnesota.
• Loudoun, Virginia.
• San Diego, California.

>>> Read the full report at The Lancet