Dr. Leila Myrick had only read about measles in medical school before a girl with the telltale rash turned up in her West Texas emergency room in late January.

The child, who had no immunity to the highly contagious disease but had an underlying respiratory condition, would become one of the first known cases in Gaines County, the epicenter of the nation’s largest outbreak in six years. Nearly 160 known people have been infected since, including 22 people who have been hospitalized. And last week, a school-age child with no underlying conditions died, marking the first measles death in a decade. The outbreak spread across rural counties and is now suspected to have caused an outbreak nearby in New Mexico.

Myrick, a 38-year-old family medicine and obstetrics physician in the tiny town of Seminole, Texas, looked back to medical texts to learn more about the disease, once thought to be nearing eradication in the United States. Now, she's treated nearly a dozen cases and counting. In just over a month’s time, the rural doctor has become one of the nation's only doctors with firsthand experience of how infectious, and serious, measles is. And she is an unwitting expert in a disease she never thought she'd treat.

“Now we’re literally seeing when you don’t vaccinate, this is what happens,” Myrick said.

Since vaccination rates have dropped across the United States, doctors and health staff across the country are rethinking preventable diseases such as measles that hadn't been seen in generations.

The United States declared measles eliminated in 2000. But American immunization rates have decreased in schools – which normally require vaccines for attendance – below the 95% herd immunity threshold needed to prevent outbreaks, according to the Centers for Disease Control and Prevention. Drops have been attributed to distrust and misinformation around public health and vaccination that led to increases in medical or religious exemptions.

“Measles is the tip of the iceberg,” said Dr. Daniel Kuritzkes, chief of the infectious diseases division at Brigham and Women’s Hospital and a professor at Harvard Medical School. “There are other vaccine-preventable illness that we could see recurring, which could also have catastrophic consequences.”

In Gaines County, just over 80% kindergartners were vaccinated against measles last school year. In the county, Loop Independent School District, with about 150 students, had less than half of students vaccinated.

As of Tuesday, over 100 of Texas' 159 cases were in Gaines County. Most cases are in children, predominantly among those who are school-age. All but five cases were among people who weren't vaccinated or had no known vaccination status.



Dr. Leila Myrick, a family medicine and obstetrics physician in Seminole, Texas, is on the frontlines of the country's largest measles outbreak in six years.

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