Second Death Reported as Measles Cases Climb in Texas, New Mexico

In a Health Alert Network advisory today, the CDC said more cases are expected in the rapidly growing outbreaks in Texas and New Mexico. The agency also said that, with spring and summer travel season under way, healthcare professionals should be vigilant for cases of febrile rash that meet the measles definition and should ensure that patients planning international travel are up to date on MMR vaccine.

Spotlight on HHS Secretary
The outbreak is putting a spotlight on new Department of Health and Human Services Secretary Robert F. Kennedy Jr., a longtime vaccine critic who has promoted the debunked theory that the MMR vaccine is linked to the rise in autism diagnoses. Despite the existence of numerous studies that have found no such association, Reuters reports today that the CDC is planning a large study on vaccines and autism. 

Although Kennedy said in an opinion piece on the Fox News website that vaccines protect children from measles and contribute to community immunity, he also said the decision to vaccinate is a personal one, that improved sanitation and nutrition prior to introduction of the MMR vaccine in 1960 were responsible for most of the reductions in measles deaths, and that good nutrition “remains a best defense against most chronic and infectious illnesses.” 

In contrast, communication from both Texas and New Mexico health officials has emphasized that vaccination is the best way to prevent measles.

In a subsequent interview, Kennedy also promoted the benefits of vitamin A for treating measles, which has no specific antiviral treatment. A health alert from the NMDOH notes that while vitamin A may be administered in children and infants who have severe measles as part of supportive management, it will not prevent infection and should not be given prophylactically.

Vaccination First Line of Defense
During a media briefing held today by the Infectious Diseases Society of America, public health officials from New York and Missouri addressed the Texas outbreak and some of Kennedy’s comments.

We in the infectious disease and medical community know that measles vaccination is our first line of defense against measles in children and adults, and we strongly encourage vaccinations,” said Dial Hewlett, MD, of the Westchester County Department of Health. “That’s not to say that sanitation is not important; it’s just to say that the vaccine is the most important thing as far as preventing the occurrence of measles in an outbreak.”

Mati Hlatshwayo Davis, MD, director of health for the City of St. Louis, said vitamin A is not a replacement for the MMR vaccine. She explained that while vitamin A supplementation has been shown to reduce measles mortality in malnourished populations in resource-limited countries, where vitamin A deficiencies are common, the benefits in well-nourished populations are unclear. 

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“We in the infectious disease and medical community know that measles vaccination is our first line of defense against measles in children and adults, and we strongly encourage vaccinations.”

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Davis also noted that high-dose vitamin A therapy carries safety risks, including liver damage and increased intracranial pressure.

While vitamin A may support treatment in severe cases, it does not stop the spread of measles or provide long-term protection,” she said. “Only vaccination can do that.”

Chris Dall is news reporter at CIDRAP. This article is published courtesy of the University of Minnesota’s Center for Infectious Diseases Research and Policy (CIDRAP).