More US states are reporting measles cases as the Texas outbreak expands, surpassing last year’s total, amid vaccine misinformation and hesitancy.
The Texas outbreak could take a year to get under control, one health official said – during which time it may spread to more states. Yet the parents of the six-year-old girl who died of measles in Texas have spoken against measles vaccination as misinformation continues to proliferate, including from figures such as the US health secretary, Robert F Kennedy Jr.
“I never thought in 2025, we would be looking at this resurgence of measles,” said Katherine Wells, director of Lubbock Public Health. “And I didn’t know it’d be in my backyard, either.”
On Thursday, several other states reported updates on measles. Ohio reported its first case of 2025 and Maryland announced two new cases. Both states have linked the cases to international travel. Alabama also announced that an unvaccinated child with measles traveled through the state, while Kansas has confirmed eight cases of measles among children this month.
Measles cases have also been confirmed in Alaska, California, Florida, Georgia, Kentucky, New Jersey, New York, Pennsylvania, Rhode Island, Vermont and Washington.
“Measles is one of the most contagious diseases in the world,” Lucia Donatelli, chief of Maryland’s Center for Immunization, told reporters on Thursday evening.
“It can linger in the air for up to two hours after the person leaves the room, so it is highly transmissible. And the best way that we have to prevent measles is by vaccination.”
The rise in international cases comes soon after the US government laid off and put on leave thousands of USAID employees and contractors, many of whom worked in countries with high rates of measles.
But the highly contagious virus is also on the rise in the US.
There were 285 cases of measles reported in the US last year. So far, there have been 378 confirmed cases in the first few months of 2025.
Some 309 of those cases are in Texas, which has had 40 hospitalizations and one death of an unvaccinated six-year-old girl from measles.
The outbreak has spread to New Mexico, where 42 cases, two hospitalizations, and one death of an unvaccinated adult have been confirmed. It’s also spread to Oklahoma, which has announced four probable cases.
Officials suspect the true number of cases is higher; typically, there are one to two deaths per 1,000 cases. The under-reporting means “we’re not at a point where we know where all of our cases are”, Wells says, which makes it challenging to stop the spread.
Families with multiple cases may not get everyone tested. And “there’s some hesitancy in interacting with the medical community”, Wells says.
The vast majority of cases are among people who have not been vaccinated.
“There’s a lot of vaccine hesitancy in Gaines county, which is where the majority of the cases are,” Wells says. There’s social pressure against getting vaccinated and misinformation has taken root over the past two decades, she says.
The parents of the child who died appeared in a video on Monday with Children’s Health Defense, the anti-vaccine organization previously helmed by Kennedy.
“We would absolutely not take the MMR,” said the girl’s mother, referring to the measles, mumps and rubella vaccine. “The measles wasn’t that bad. They got over it,” she said of her four other children.
“It’s not as bad as the media is making it out to be,” the father said through a translator. Both parents fought back tears throughout the interview.
Kennedy has shied away from directly recommending vaccinations during this outbreak while also promoting alternative treatments. He has also suggested that the Texas child was unhealthy or malnourished, despite medical reports that she was healthy and had no underlying conditions.
Health departments in cities like Lubbock, where the hospitalized children with measles are being treated, have created mass vaccination clinics where anyone can get the MMR vaccine free of charge.
“We’re trying to remove every single barrier to get vaccinated,” Wells says. “And then we’re working more with messaging from trusted leaders about the importance of vaccination.”
But so far, the Lubbock clinic has only given out about 300 more vaccines than they usually would over the past few weeks.
Without widespread vaccination, the outbreak could continue for another year, she says. Other recent outbreaks have been in densely populated areas, but these cases are spread over 11 counties in Texas, plus New Mexico and Oklahoma.
“We have a large, spread-out population where we’re going to keep seeing measles pop up,” Wells says. “It’s going to take a lot of time to change the perception of vaccines, get people vaccinated, and then get to a point where there won’t be any vulnerable people left for measles to find.”
From the first two cases, Wells knew “this is going to be big”. Two children hospitalized in Lubbock tested positive, which meant there was more community spread happening under the radar.
Now, she worries about someone stopping at one of the major rest stops along Texas highways and spreading measles far beyond the state.
“That’s how easily transmissible measles is,” Wells says – and outbreaks can ignite anywhere that the vaccination rate is low.
In Ohio, an unvaccinated resident tested positive for measles after international travel, according to the state department of health.
Maryland officials also announced two more cases of measles in unvaccinated international travelers. They flew into Dulles international airport on 5 March – the same day as the previous case in Maryland, though at different times.
These cases are not associated with that previous case or with the measles outbreak in New Mexico, Texas and Oklahoma, Maryland health officials say.
These patients, who traveled internationally together, also visited several locations throughout the Washington DC area, including four visits to a healthcare center as well as trips to the metro, a shuttle bus at National airport, and a car dealership, over the course of 12 days.
If patients suspect they were exposed to measles, they should seek care immediately – but it’s very important to notify healthcare providers of potential measles cases, so that others in the facility don’t get sick.
“Call ahead to tell the place where you are going to, to tell the provider where you are going to, that you’re coming in because you may have possibly been exposed to measles,” Donatelli says.
“That way, the provider can go ahead and make the proper arrangements so that you could be seen safely and quickly – and at the same time, they can protect other people.”
