Since the start of 2019, more than 1,200 cases of measles have been confirmed in 30 states, including Texas. That marks the most reported cases in the United States since 1992, according to the Texas A&M Health Science Center.

The 1,203 individual cases reported to the CDC as of Aug. 15 are more than triple the 372 cases reported in 2018. The disease was declared eliminated in the United States in 2000.

The majority of people affected by the virus were not vaccinated, and more than 75% of the reported cases are linked to outbreaks in New York state, according to the Centers for Disease Control and Prevention.

In addition to Texas and New York, other states that have reported cases to the CDC are: Alaska, Arizona, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, New Mexico, Nevada, New Hampshire, New Jersey, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Virginia and Washington.

Measles is a highly contagious virus spread primarily through coughing and sneezing. It does not take close contact to spread because the virus can live on surfaces for up to two hours, the A&M HSC release states, and people with measles are contagious up to four days before and after a rash appears.

The CDC states measles is so contagious that if one person has the infection, up to 9 out of 10 people around them will also become infected if they have not been vaccinated.

According to the A&M HSC release, people without an immunity to the disease have about a 90% chance of catching measles.

The most effective way to prevent measles and its complications is to get the measles, mumps and rubella (MMR) vaccine, Columbus said.

The CDC recommends children receive two doses of the MMR vaccine: one at 12-15 months of age and another at 4-6 years old.

Though the disease was declared eliminated in the United States almost 20 years ago, the CDC states, it is still common in many other parts of the world. Multiple factors are contributing to the increased number of measles cases in the U.S., including the disease spreading in communities with pockets of unvaccinated people and an increase in unvaccinated travelers who get the infection while out of the country.

Measles is particularly serious for children under the age of 5, adults older than 20 years old, pregnant women and those with compromised immune systems, according to Dr. Cristie Columbus, infectious disease expert and associate dean for the Texas A&M College of Medicine.

Measles symptoms, as described by the CDC, begin with a fever followed by a cough, runny nose and red eyes. Then, a rash of tiny, red spots appears, starting at the head and spreading across the rest of the body.

The rash can last for a week, and the coughing can last for 10 days.

Common complications, Columbus said, are ear infections and diarrhea, but more serious complications can include pneumonia and encephalitis, a swelling of the brain.

In the most serious cases, the CDC states, the infection can result in death.

“Pneumonia is the most common cause of death from measles in young children,” Columbus noted in the HSC release.

Anyone who suspects they might have measles should isolate themselves and contact the doctor’s office or emergency room before arriving so they can prevent others from potentially contracting the disease, the HSC recommends.

People can have a blood test done by a primary care provider to determine if they have the proper immunity to measles, then can get the MMR vaccine if needed.

There is a statewide protocol in Texas public school districts must follow if there is an outbreak at a school or another nearby school, College Station school district spokesperson Chuck Glenewinkel said, noting College Station has not had an incident since school started last week.

Bryan school district spokesperson Matthew LeBlanc said there were no cases in the first two days of school in the Bryan school district, but the district continues to “strongly encourage” parents to make sure their child has the MMR vaccine.

According to the CDC, the vaccine is “very safe and effective” at preventing measles, mumps and rubella, but acknowledges there are possible side effects. Most people do not experience any side effects, but those who do most frequently report fever, rash, temporary pain and stiffness in joints or soreness or swelling at the injection site.

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