Measles update: Hello, Ohio

Put another state on the board, Johnny.

A measles outbreak in Kansas doubled in less than a week to 23 cases and has “a possible link” to outbreaks in Texas and New Mexico that have sickened more than 370, the state health department said Wednesday.

And health officials in Ohio say a single case identified in Ashtabula County has spread to nine others. Even before these two growing clusters were reported, the number of measles cases in the U.S. had already surpassed the case count for all of 2024, according to the U.S. Centers for Disease Control and Prevention.

[…]

In Ohio, 10 cases are in Ashtabula County and a separate visitor in Knox County exposed people there and in several other counties, the state health department said. A measles outbreak in central Ohio sickened 85 in 2022.

“Given the measles activity in Texas, New Mexico, and other states around the country, we’re disappointed but not surprised we now have several cases here in Ohio and known exposure in some counties,” said Ohio Department of Health Director Dr. Bruce Vanderhoff. “This disease can be very serious, even deadly, but it is almost entirely avoidable by being properly vaccinated.”

That story is from Wednesday, so the case count is outdated and we don’t know yet if this outbreak is related to any of the others. But it looks now like the Kansas and Oklahoma outbreaks are indeed connected to Texas.

Twenty-three measles cases have been reported in Kansas, and the state health department said they could be linked to an ongoing outbreak that has infected at least 379 people across Texas, New Mexico and Oklahoma.

“The confirmed cases in Kansas have a possible link to the outbreaks in Texas and New Mexico. While genetic sequencing of the first Kansas case reported is consistent with an epidemiological link to the Texas and New Mexico outbreaks, the source of exposure is still unknown,” Jill Bronaugh, communications director for the Kansas Department of Health and Environment, said in an email Wednesday.

Children account for 21 of the Kansas cases, and 20 of the cases are in people who are unvaccinated.

[…]

Tuesday’s update from the Oklahoma State Department of Health indicates links with the Texas and New Mexico cases.

“All cases are linked through exposures to household or extended family; and initial cases reported exposure to the measles outbreak in West Texas and New Mexico. At this time, no cases have resulted from exposure to public settings,” the agency said.

The bottom line is that while this outbreak started in a tiny and isolated West Texas county among a small Mennonite community, it has spread well beyond that by now.

Meanwhile, back in West Texas, there’s a new problem for doctors and health officials to deal with.

Medical disinformation connected to the West Texas measles outbreak has created a new problem. Children are being treated for toxic levels of vitamin A.

Covenant Children’s Hospital in Lubbock confirms it is treating children with severe cases of measles who are also suffering from vitamin A toxicity. According to the hospital, they have admitted fewer than 10 pediatric patients who were all initially hospitalized due to measles complications but have elevated levels of vitamin A that is resulting in abnormal liver function.

Health and Human Services Secretary Robert F. Kennedy Jr. directed the CDC to update its measles guidance to promote the use of vitamin A. Kennedy, a vaccine skeptic, recommended in an article published March 2 on FOX News to take vitamin A under the supervision of a physician for those with mild, moderate and severe infections.

During a March 4 interview on Fox News, Kennedy suggested that therapies such as the use of cod liver oil — which contains vitamins A and D — were “working” in treating measles patients.

There are reports from the West Texas area that cod liver oil is in high demand and a big seller at area pharmacies.

But the hospital is informing the public to reduce consumption of vitamin A and has warned that excessive amounts of it may result in significant adverse effects.

There is no evidence that taking vitamin A will prevent measles.

CNN has more on this.

Vitamin A is most useful for measles support in people who have a specific deficiency, and studies suggesting its use mainly draw on evidence from low-income countries where that deficiency is common. The patients in West Texas are generally well-nourished, said Dr. Lesley Motheral, a pediatrician in Lubbock, so experts say it’s unclear how beneficial the vitamin might be in this setting.

Vitamin A has an important role in immunity and vision. It’s fat-soluble, so when someone takes too much, it can accumulate in organs like the liver. Excess vitamin A can cause dry skin and eyes, blurry vision, bone thinning, skin irritation, liver damage and other serious issues. In pregnant women, excess vitamin A can lead to birth defects.

Patients with toxicity can receive supportive care like fluids for low blood pressure or moisturizers for dry skin and eyes, Motheral said. But more serious damage will need to be evaluated and given further management.

“Recovery for patients with acute toxicity can be rapid when the vitamin is discontinued,” she said. “Chronic toxicity can affect bones, brain and of course the liver. … Sadly, some of the more serious problems with vitamin A toxicity are not always reversible.”

The Council for Responsible Nutrition, a trade association for dietary supplement and functional food manufacturers, issued a statement Wednesday warning parents against using high doses of vitamin A to try to keep their children from getting measles.

“While vitamin A plays an important role in supporting overall immune function, research hasn’t established its effectiveness in preventing measles infection. CRN is concerned about reports of high-dose vitamin A being used inappropriately, especially in children,” the statement says.

I dunno, man, I feel like we’ve had folk wisdom about the dangers of too much of a good thing for literally the entirity of human civilization. I know no one trusts doctors and scientists anymore, but could they maybe read the story of King Midas? I’m just saying.

And the fun doesn’t stop there for the people trying to respond to this thing.

The Lubbock public health director said Wednesday local efforts to fight a measles outbreak will be affected by the federal government’s announcement that it’s pulling $11 billion in COVID-era funding for public health departments.

A brief notice sent to Texas local public health departments late Tuesday by the Texas Department of State Health Services, or DSHS, provided no real specifics.

“DSHS was notified that the federal grant funding for Immunization/COVID, Epidemiology Laboratory Capacity (ELC/COVID), and Health Disparities/COVID, is terminated as of March 24, 2025,” the notice from DSHS Associate Commissioner Imelda Garcia, stated. “The Texas Department of State Health Services (DSHS or System Agency) is issuing this notice to pause all activities immediately. Please do not accrue any additional costs as of the date of this notice.”

DSHS did not respond to requests for details on exactly how much is unspent COVID-19 era grant money or how many local health departments will be impacted. The grants were issued to help states shore up their public health systems following the pandemic.

But Katherine Wells, Lubbock’s public health director, said it will definitely impact her office’s work combating the spread of measles. Lubbock has been using three grants to help pay for extra temporary staff, a part-time nurse and a full-time epidemiologist to help with vaccinations, answering phones and working with testing of patients. Two of the city’s three grants were not to expire until 2026.

“It’s kind of crazy to have this funding cut,” Wells said. “I don’t have a savings account in public health.”

I would like to point out that the Texas Division of Emergency Management, which is a subsidiary of the Governor’s office, has the power and the funds to direct resources to affected areas in times of emergency. This is how Houston got funds for post-Beryl and derecho cleanup, for example. Greg Abbott could help out here, is what I’m saying. To be fair, he shouldn’t have to, because those funds should never have been cut in the first place. Maybe someone should let Donald Trump know that this is hurting his voters. My point here is that this doesn’t have to be the final word, and the burden doesn’t have to fall entirely on Katherine Wells’ shoulders.

And finally, here’s your Texas case update.

The number of measles cases in Texas has reached 400 infections as of Friday, March 28 — a jump of 22% since the state’s last update on cases Tuesday.

The Texas Department of State Health Services said a total of 41 people have been hospitalized. One school-age child who was not vaccinated died in February.

[…]

As of Friday, almost all of the cases have been in the South Plains and Panhandle regions of western Texas, with the exception of 10 cases in Lamar County, about 100 miles northeast of Dallas.

But Tarrant County health authorities have warned that there’s a “high risk” of measles cases here due to lower vaccination rates. The virus is so contagious that if one person has it, up to 9 out of 10 people nearby will become infected if they are unvaccinated.

[…]

Here are the latest numbers by Texas county, with increases since Tuesday:

Andrews: 1 (new)
Cochran: 8 (up from 7)
Dallam: 7 (up from 6)
Dawson: 14 (up from 13)
Ector: 4 (up from 2)
Gaines: 270 (up from 226)
Garza: 1
Hale: 1
Hockley: 2 (up from 1)
Lamar: 10 (up from 5)
Lamb: 1
Lubbock: 23 (up from 10)
Lynn: 1
Martin: 3
Terry: 38 (up from 37)
Yoakum: 15 (up from 13)

That’s a big increase from Tuesday’s report – 73 new cases, mostly in Gaines County, though that bump in Lamar, northeast of Dallas and hundreds of miles from the initial outbreak, should be worrying. Not much else to say at this point, but do go read Your Local Epidemiologist for a final word. She notes that we’re on the five-year anniversary of COVID-19, and for a variety of reasons we are in a much worse position to deal with outbreaks exactly like this one, even though we know a lot more about how to handle them. On that grim note, have a nice weekend. The Chron has more.

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One Response to Measles update: Hello, Ohio

  1. Flypusher says:

    “ Maybe someone should let Donald Trump know that this is hurting his voters.”

    What good would that do? He does not care.

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