West Texas. Wide open highways, sprawling landscapes. Really beautiful country. But unfortunately, now also home to the largest measles outbreak in the state in 30 years. You probably know measles from its signature spotted red rash, but otherwise, you know, we really haven't had much reason to talk about it since it was essentially eliminated here in the United States back in 2000. For a long time, we simply didn't have any new cases. Nobody was getting sick of measles. And that, of course, was thanks to the development of the measles vaccine in the 1960s. But the thing about measles is that it is one of the most contagious viruses on the planet, and that means the vaccination rate doesn't have to drop by too much for it to start to spread. The U.S. Department of Health and Human Services, they said a 95% vaccination rate goal for kindergartners. What does that mean? Two doses of the measles, mumps and rubella vaccine. MMR vaccine to help prevent outbreaks. Now that is a high number. But when a virus is very contagious, you need a higher vaccination rate to keep it at bay. And when it's lower, the virus has the opportunity to quickly take hold. And that is exactly what we are seeing now in West Texas. That's where the outbreak started in this tight knit, rural, under vaccinated Mennonite community.

We have the first reported death for measles in the outbreak that has infected more than 100 people. 100.

But again, because it is so contagious, more and more measles cases are starting to be reported in other parts of the state. So with all that in mind, I recently traveled down to Texas to learn more about the outbreak, how it exactly started, how it could be contained, and overall how the community is feeling about the situation. I'm Doctor Sanjay Gupta and this is Chasing Life. Okay, let's start with the basics. Measles is a virus, and it spreads when someone who is infected breathes, coughs, or sneezes, and then another person inhales those infected droplets. Now, I've said this a couple times: it is highly contagious. But what does that mean exactly? Well, think of it like this. It is so contagious that it's estimated that someone with measles can infect nine out of ten unvaccinated close contacts, and it can also linger in the air, and it can linger on surfaces up to two hours after an infected person has left the room. Symptoms will typically begin 10 to 14 days after exposure. Think about that. It can be hard to remember what you were doing, where you were 10 to 14 days ago. The symptoms will typically include a high fever, cough, runny nose, conjunctivitis or red eyes. And then again, most notably a red blotchy rash all over the body. Now what I think is important to note, especially if you have children. Measles can cause serious respiratory and neurological complications. About 1 in 5 unvaccinated people in the United States with measles will be hospitalized. 20%. This is the reality doctors in West Texas are now facing.

We've had over 15 patients admitted here in our children's hospital with measles over the past several weeks.

That's doctor Lara Johnson. She's the chief medical officer, a covenant children's in Lubbock, Texas. It's about an hour and a half northeast of Gaines County. Now, it is worth pointing out so many of the people who get infected with measles, who get sick, who need to be hospitalized. They are children.

So how do you how do you even begin to approach? As a patient comes in, what do you what do you do for them?

Well, you know, I would say the acute management, it's not that different than other viral illnesses that we deal with. So one of the most important things is making sure that we're identifying those patients as quickly as possible so we can limit exposure to other patients and staff. And then of course, assessing what their needs are. Most of the patients who've been admitted have had respiratory issues. They've been needing supplemental oxygen and respiratory support to help them get over the viral pneumonia part that we see with measles.

Is the pneumonia the the the worst part? Is that what's really bringing them in the hospital?

That's certainly what we've seen. We know, you know, the thing that we worry the most about is having neurologic issues as well.

I mean, you hear about, you know, people getting really sick, maybe even dying, but is is the medical care different today than it was decades ago?

You know, that's a that's a good question. I think overall we're better at taking care of acute respiratory illnesses in children now than we have been in the past. We're probably also better at taking care of some of those acute neurologic things, just because our ability to provide supportive care may have improved. But I think even even with those things, you know, measles can still be deadly. We know that from from previous experiences, measles still can have serious consequences. And even one of the things that I think is sort of most concerning about measles is there is a condition that can develop years and years later after having measles that is neurologically devastating and fatal and happens, you know, seven plus years after the fact. And I don't think we've made any progress in, in some of those things. So, you know, I think our, our ability to provide acute supportive care continues to improve, which is great, but that that doesn't solve all those problems necessarily. And, you know, one of the other impacts, just thinking about a community with measles is it also has kind of a fairly long incubation period and then a long period of time in which symptoms may develop. If you're exposed, that's a 21 day period of potential quarantine. So, you know, that can have such a significant impact on students missing school for that period of time, parents missing work for that period of time. Employers having employees that can't come to work for that period of time. Just the sort of ripple effect of an outbreak like this can be really significant in lots of other ways.

And that's exactly why Doctor Jennifer Shuford is trying to stop it.

We haven't had a big outbreak out here in decades.

She's the commissioner for the state health department.

So what do you from from a state health standpoint? What can you do about it?

I think the number one thing that we're trying to push is vaccines. We've had this same MMR vaccine mumps, measles, rubella vaccine since the 1960s. It's got a proven track record. It's really it builds strong immunity. It benefits really outweigh the risks. And we've got such a track record with this vaccine. And we know it can protect people during these measles outbreaks that we are really trying to get everybody vaccinated.

What do you think the next weeks and months is going to look like?

I think that we're going to continue to see cases and what the next few months look like kind of depends on how effective we are at getting messaging out about, you know, making sure that people get vaccinated, that they stay at home if they're sick and and really trying to push that message through really trusted community leaders.

You and I have been doctors for some time. I think me a bit longer than you, but. But have you ever seen measles before?

No. And I'm an infectious disease physician. I've never diagnosed a case. It's because, you know, measles was declared eliminated from the United States back in the year 2000 because of the effectiveness of that vaccine. And it's only now with falling immunization rates, not just here in Texas, but across the country and around the world, that we're starting to see more of these outbreaks.

What is your sentiment? I mean, you're an infectious disease doctor, epidemiologist, obviously helping run the state's health response. Frustrated, depressed, angry. What is your sentiment?

Restless and impatient. I want to make sure that we get this message out. It is on us now to try to help get the message out about the safety and the strength of this vaccine, and really trying to let people know the benefits that so that we can contain it. I know that that people have concerns about vaccines and that is okay. But it's time now to talk to your health care provider about those vaccines and why they might be right for you and your family. Because we really do need to contain this.

But that has proven to be difficult as the virus and the worry continues to spread. More when we come back.

Get vaccinated. That is the message I heard over and over again when I visited West Texas. Public health departments are trying to make it as easy as possible. Even setting up these free pop up clinics that are now open seven days a week.

You just set this up this week.

Set it up this week.

Doctor Ron Cook is with the Lubbock Health Authority.

We've got plenty of vaccine, So we just need people to come get it.

And are people coming in?

They did 13 yesterday 23 yesterday 23.

Okay.

Gotcha. And so. Yeah.

So so who is who is it these these 23 folks? How would you describe them? Who are they?

Some of them haven't been vaccinated, a little older kids, for whatever reason, we can look and see that they've had no vaccines whatsoever, but which means they're 6 or 7, eight years old and haven't any vaccine. So let's get you started. Let's at least get this one done and encourage them to continue to be fully vaccinated for all the other things that they should be. We are offering all the free vaccine. Come get your vaccine. If you're not vaccinated, please come get it so we can stop it because we know how fast this spreads. We thought Covid spread fast and we thought norovirus spreads fast, but measles spreads exceedingly fast.

It's it's that contagious. I mean, it.

Is the most infectious virus that we know about.

How would you just sort of for people who are sort of dipping into what's happening in West Texas from around the country, around the world, like how would you describe what's going on here?

We have pockets that are not well vaccinated, but these individuals like in in Gaines County down there that that come to shop here, we have Costco and Sam's and Walmart's and they come here to do big shopping on the weekends. And they bring their kids and they walk through Costco or they walk through these big shopping centers, and then they're exposing these people. And we know how infectious measles is. Right. So it really does. We we've we've had a number of cases hospitalized. And so they hear about it. It's on the news now. So there we have the worried well plus the ones that potentially can get pretty sick.

Owen was a micro preemie. So we spent the first hundred and 2 or 3 days in the hospital. And since then, you know, with his weakened immune system and everything he went through, we just don't know how he would handle the measles.

Amy and Eric Gandy have lived in Lubbock for 20 years. Amy moved here to play volleyball for Texas Tech. And Eric is a cotton farmer now. Both their kids, 11 year old Owen and nine year old Riley, are vaccinated. But Owen is immunocompromised, and as a result, he could be more vulnerable to a measles infection.

And just I'm starting to get an idea that the sentiment down here are people worried? I mean, is this something that's talked about?

I think you just you start reading more and more and you realize it's on national news and you want to learn more about the disease because you don't you haven't really heard of what it actually does. And it's a lot more alarming than I thought it would be and how contagious it is. And will the vaccine be effective for all of us? Because it's, I think, 97% effective, right? Are we going to be that 3% or are we going to be safe? So yeah, it is a little alarming.

You know, I have three kids and I'm just trying to imagine how I would feel like does it make you angry? Does it make you discouraged to not have that herd immunity?

Well, I think that the whole conversation about immunities, that immunization is less and less about the vaccines and their effectiveness or their side effects, and it's more about politics and religion, that's a different conversation for a different day with somebody else. But, you know, there's a whole other side of that story, and it's about, you know, what we learn from Owen being premature. That there's a whole group of people, whether it be because of health or age or allergies or something else, they can't get those vaccines, so they don't even have a choice whether or not to be vaccinated. So then it's up to us who can or do get vaccinated to create that herd immunity that can protect them and everybody else that's at risk. All right. So I just I mean, it's really I think it's time that everybody like, takes a look just at your political reasons or your religious reasons, kind of think about that group of people that really take a deep look into what it is that you really believe and why you really believe that and see if not, there's just even a little bit chance, just for a little bit, that you could put somebody else's interest ahead of yours, especially since there's a group of people that can't make that choice, whether the vaccines can work for them or not.

I guess I just think it's what you do and to do your part for society, and I just don't think it's an option not to.

Now, if you're a new parent, that means getting your child two doses of the MMR vaccine, the first typically between 12 and 15 months, and the second around age four before starting school. This usually protects people against measles for life. Now, if you have an older child or you yourself are not vaccinated, officials say it is not too late. And as we saw in Texas, every shot can really make a difference. Thanks for listening. Chasing life is a production of CNN audio. Our podcast is produced by Eryn Mathewson, Jennifer Lai, Grace Walker, Lori Galareta, Jesse Remedios, Sofia Sanchez, and Kyra Dahring. Andrea Kane is our medical writer. Our senior producer is Dan Bloom. Amanda Sealy is our showrunner, Dan Dzula is our technical director, and the executive producer of CNN Audio is Steve Lickteig, with support from Jamus Andres, John Dianora, Haley Thomas, Alex Manasseri, Robert Mathers, Leiny Steinhardt, Nicole Pesaru, and Lisa Namarow. Special thanks to Ben Tinker and Nadia Kunang of CNN Health and Katie Hinman.