State offers specific measles guidance for 10 West Texas “outbreak” counties

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The Texas Department of State Health Services this week released an updated set of vaccine recommendations for 10 West Texas counties at the center of an ongoing measles outbreak that has so far claimed two children’s lives and infected more than 500 people in the region.

Although 22 Texas counties have reported at least one measles case, the state in recent weeks has been designating counties with the most measles cases as “outbreak areas.” On Monday the outbreak area expanded from six to 10 counties: Cochran, Dallam, Dawson, Gaines, Garza, Lamar, Lynn, Lubbock, Terry and Yoakum.

The recommendations for those living or traveling to the outbreak counties covers Texans of all ages, not just young children. The agency stressed that vaccination is the best defense against measles and that two doses of the measles-mumps-rubella or MMR vaccine prevents more than 97% of measles infections.

Among DSHS’ recommendations for outbreak areas:

• Children 6 to 11 months receive an “outbreak” dose of the MMR vaccine if they live or are traveling to an outbreak county
• Children over 12 months old who have not been vaccinated with the MMR vaccine receive one dose and follow up with a second at least 28 days later
• Teens and adults should also be up to date on their MMR vaccination
• Adults born between 1957 and 1968 who only received one MMR vaccine from that time period should consider getting one dose of the current vaccine
• Adults born before 1957, pregnant women, and people with severe immunodeficiency are not recommended to receive any dose of MMR vaccine

More information on outbreak area guidance can be found here.

The guidance was offered in a 30-slide presentation by Dr. Dr. Varun Shetty, DSHS chief epidemiologist, during the state agency’s public health funding and policy committee meeting.

Shetty also stressed that there is no specific antiviral therapy for measles and that “vitamin A is not a preventative treatment.”

Vitamin A is not a cure for measles. But for those with severe vitamin A deficiencies it can lessen symptoms.

It’s a therapy long touted by Health and Human Services Secretary Robert F. Kennedy Jr. as a treatment for measles, a claim discounted by physicians because most Americans get enough vitamin A in their regular diet.

Because the public is asking questions about using vitamin A to relieve measles symptoms, the state agency has been recommending that patients interested in vitamin A consult with their health care provider about it. The state agency also offers this guidance:

• Under the supervision of a healthcare provider, vitamin A may be administered to infants and children in the United States with measles as part of supportive management.
• Also under physician supervision, if vitamin A is recommended, it should be administered immediately after a measles diagnosis and repeated the next day for a total of 2 doses.

The state health agency cautioned that inappropriate dosing can lead to vitamin A toxicity.

The recommended age-specific daily doses are of vitamin A, according to DSHS is 50,000 IU for infants younger than 6 months, 100,000 IU for infants 6–11 months and 200,000 IU for children 12 months and older

The inclusion of vitamin A comes a month after the Centers for Disease Control and Prevention made a similar announcement on Feb. 28, two days after the first West Texas child died of measles.

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