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The cases have been concentrated in a “close-knit, undervaccinated� Mennonite community, Texas Department of State Health Services spokesperson Lara Anton said. Gaines County is highly rural, so many of the families send their children to small private schools or are homeschooled, Anton said.

“The church isn’t the reason that they’re not vaccinated,� Anton said. “It’s all personal choice and you can do whatever you want. It’s just that the community doesn’t go and get regular health care.�

Anton said the state is working with local health officials to increase screening and vaccination efforts. Health officials are also working to educate school officials on identifying measles symptoms and encouraging families to vaccinate their kids.

The outbreak is in a sparsely populated swath of rural Texas, near the New Mexico border, and has spread from its epicenter in Gaines County to include single-digit cases in Lynn, Terry and Yoakum counties.

One case was reported in Lea County, New Mexico, where to a measles case in an unvaccinated teenager. The New Mexico Department of Health said the teen had no recent travel or exposure to known cases from the Texas outbreak.

Texas Department of State Health Services data shows there were 49 cases of measles in Texas in 1996. In 2013, there were 27 cases reported after a person who traveled to Asia returned and interacted with a vaccine-hesitant community, the state reported.

Measles is a highly contagious virus that can survive in the air for up to two hours. Up to 9 out of 10 people who are susceptible will get the virus if exposed, Before the vaccine was introduced in 1963, the U.S. saw some 3 million to 4 million cases per year. Now, it’s usually fewer than 200 in a normal year.

The U.S. saw , including an outbreak in Chicago that sickened more than 60.

Vaccination against measles, a two-shot series, is required for most U.S. kindergarteners in order for them to enroll in public school.

Texas law allows children to get an exemption from school vaccines for reasons of conscience, including religious beliefs. The percentage of kids with exemptions has risen over the last decade from 0.76% in 2014 to 2.32% last year, according to state .

Gaines County has one of the highest rates in Texas of school-aged children who opt out of at least one required vaccine, with nearly 14% of K-12 children in the 2023-24 school year. Health officials say that number is likely higher because it doesn't include many children who are homeschooled and whose data would not be reported.

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