HAYS COUNTY — A virtual town hall was hosted by Hays County Commissioner Michelle Cohen and State Rep. Erin Zweiner Thursday, March 6, to discuss the current situation surrounding measles in Hays County.
The conversation on measles has become more recent as, according to both the county and the Hays County Health Department (HCHD), there was a potential for exposure of residents to a person — a resident of Gaines County — who tested positive for measles and visited the Texas State University campus and San Marcos Friday, Feb. 14.
“That trip or tour happened in San Marcos, Texas, at the Texas State University [campus] on February 14 or Valentine's Day. They were here in the community approximately from one o’clock or two o’clock, all the way until 8 p.m.,” explained Matthew Gonzales, health department director. “What we know about measles is that it is an airborne virus. It also sticks to surfaces. And what it does, that specific virus can last up into the air and or the surfaces for up to two hours. So, we had to be able to assess those sites, exposure sites, and individuals within those two-hour time periods. Where they have left Texas State at 5, we're now having to consider who was there until 7 p.m. They were at Twin Peaks until 8; we’re having to look until 10 p.m.”
The Gaines County resident was on a public tour of the university’s campus; there were up to 60 individuals exposed at one point in time at a teaching theatre and the tour group then broke into two smaller groups of 30, Gonzales said. The person did not tour Texas State during the time they were the most infectious or had the most opportunity to infect others, he continued.
“The individual traveled here a little bit before their symptoms set in, but they were 100% positive for measles and it was epilinked to Gaines County. What epilinked means is they did receive measles from an individual in the current outbreak in Gaines County. What we want to stress and emphasize is that the individual was not their most infectious during their time of travel,” Gonzales said. “An individual typically affects others four days before the onset of their rash. This individual developed their rash, I believe, six days after their visit in San Marcos, so there was very, very minimal risk and that's what we wanted to really communicate to the public. But what we know about viruses is sometimes, they don't follow all the rules that we've created for them or, I guess, thought of or researched. Sometimes they may act differently. And so, we wanted to act out of an abundance of care and making sure that we reviewed every exposed individual, just in case, if they may have been infected, although it was not likely, we wanted to make sure that we were protecting our community in doing so.”
Measles is highly contagious; if one person has it, up to nine out of 10 people nearby will become infected if they are not protected, according to the Centers for Disease Control and Prevention (CDC). It can cause serious health complications, especially in children younger than 5 years old. The CDC states that the best protection against measles is the measles, mumps and rubella (MMR) vaccine, which provides “long-lasting protection” against all strains of measles.
Symptoms of measles appear seven to 14 days after contact with the virus. These can include the following: high fever that may spike more than 104 degrees Fahrenheit; cough; runny nose or coryza; red, watery eyes or conjunctivitis; and a rash.
“It's not a fun virus to get. Kids could get pretty sick from it and adults can, as well, and the risk of complications is high. So, the risk of complications for patients that have measles is one in three, and some of those are not super serious complications. It could be ear infections, diarrhea, but then, there's also pneumonia that can happen. The hospitalization rate is one in five and the death rate is one to three per 1,000,” explained Dr. Danielle Grant, of Texas Children’s Hospital, in the town hall.
Parents, families and individuals have become more concerned about the potential exposure of measles in local areas. One of the big responsibilities as pediatricians is to answer questions and give guidance to parents, Grant said. She recommended for parents to reach out to their healthcare provider to ask questions about vaccinations, the illness in general or if they are concerned that their child or family member may have been exposed.
“Normally, we give the MMR vaccine between 12 to 15 months of age for their first vaccine and then, we do a booster between four and six years of age. So, usually, if a patient is fully vaccinated, they're going to kindergarten with two MMR vaccinations, which gives them 97% protection, which is high. The vaccine works. It's effective. It's going to be our primary source of protection and trying to achieve that herd immunity,” Grant said. “One MMR vaccine gives you 93% protection, so it's still quite good. We've had many questions about parents wanting to get their child vaccinated early. We tend to recommend that for international travel. Currently, if we're not in an area of outbreak, it's not recommended. This may change as cases may start to increase in our areas and, if any areas [is] determined an area of outbreak, then that recommendation would change. Parents are able to get their booster earlier. So, the second MMR dose can be given as early as 28 days from the first one, so, potentially in that 13 month to 4-year-old age group, parents can ask to get that second booster early. There's no medical disadvantage to doing it and it's something that they should talk with their healthcare providers about.”
Grant explained that the MMR vaccine has been around for a long time, with the first being brought to market in the '60s. The two dose series was recommended in the 1980s, with the risk of adverse events being low, Grant said.
While some may think that measles only affects children, adults can get it, as well. Dr. Beth Just with DirectMed DPC spoke about what older adults can do when they are trying to figure out if their previous vaccinations are still valid or if they have any other further questions.
“If you have your past medical information, that always helps. So, if you've had to and you were vaccinated before 1968, then you can assume that you have your immunity and you don't have to worry about what kind of vaccine it was or any of those pieces. Now, for patients who are immunocompromised and who have chronic medical conditions, like cancer or immune deficiencies or leukemia, obviously, those patients are going to be at higher risk and there are things that individuals are going to be doing in those categories in order to avoid any sort of infection,” Just said. “Now, if you know people who are in any of those categories and you have a potential exposure, I think the biggest thing that I would recommend to everyone is to avoid getting in contact with someone else who may be at high risk. The biggest thing here is for us all to watch out for each other and to be kind of preparing with what can we do to prevent the spread. We've been talking a lot about very specific things, but at the end of the day, the covering your cough, covering your sneezes, washing your hands — if you're out in public and you've been touching different things, making sure that you don't eat before you wash your hands — and that you aren't touching your face after being around other people because this incubation period and the fact that … you're very infectious before you have the terrible rash does make the possibility of a spread more high risk.”
Individuals who aren’t sure if they have had two vaccines or that they have only had one can have a blood test done to check, Just explained, but the vast majority of people don't actually need that if they are at high risk in one of these areas: “There isn't anything wrong with having an extra one. An extra MMR is not going to be dangerous to you,” she said. “It is something that … getting some people when they're traveling, if they haven't guaranteed that they've had it, it's way better to have it ahead of time than going away and coming back home from a trip with measles.”
As of right now, there is a very low risk to the overall Hays County community, Gonzales concluded. The people that “we say want to watch out” are women who are pregnant, children who are not vaccinated and those who are immunocompromised because those are the individuals who are going to be the most susceptible and at risk of developing severe symptoms.
To watch the full town hall, visit bit.ly/41DIPJj. Stay up-to-date on the public health situations in Hays County at www.hayscountytx.gov/current-public-health-situations.
