An ongoing measles outbreak that began in one of Texas' least vaccinated counties has mushroomed to 90 cases across a cluster of seven counties in the state, according to an update by the Texas Department of State Health Services on Friday.

The outbreak may have also spread across the border to New Mexico, where nine cases have been reported. In an email to Ars, Robert Nott, the communications director for the New Mexico Department of Health, said that as of today, the department has not confirmed a connection between the nine cases and any of the confirmed cases in Texas.

However, all nine of the cases are in Lea County, New Mexico, which sits at the border with Gaines County, Texas, the epicenter of the outbreak. Of Texas' 90 cases, 57 are in Gaines, which has a vaccination rate among kindergarteners of just 82 percent this school year. The lack of a clear connection between the Texas and New Mexico cases may be yet more worrying because it suggests undetected community spread and a heightened risk of transmission in Lea, the health department noted in an alert last week.

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The highly contagious virus has infected dozens of people so far, if not more, leaving at least 13 hospitalized.

A measles outbreak in an area of Texas with abysmal vaccination rates continues to mushroom, with cases doubling since Tuesday and expanding into additional counties.

A week ago, officials reported nine confirmed cases in Gaines County, at the border of New Mexico, which has one of the lowest vaccination rates among kindergartners in the state at just about 82 percent. On Tuesday, the cases climbed to 24, all in Gaines. In Friday's update, the state health department reports that the case count has now reached 48 and spread to three nearby counties, which also have vaccination rates below the 95 percent threshold that prevent vaccine-preventable diseases from spreading onward.

Gaines now reports 42 cases. There's one case reported in Lynn County to the northeast, which has a 91 percent vaccination rate. Terry County, with a vaccination rate of 94 percent, reports three cases, and Yoakum County, with a vaccination rate of 92.5 percent, reports two cases. Terry and Yoakum are both directly north of Gaines.

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An outbreak of measles in one of Texas' least vaccinated counties continues to rapidly expand, with officials reporting 24 cases Tuesday, up from just nine confirmed on Friday.

According to an update by the Texas Department of State Health Services (DSHS), all 24 cases identified in the two-week-old outbreak are in unvaccinated people. Nine of the patients (37.5 percent) required hospitalization.

Most of the cases are in children. DSHS provided an age breakdown that listed six cases as being in infants and young children between the ages of 0 and 4. This is the age group most vulnerable to measles because they have a heightened risk of complications from the disease and may be too young to be fully vaccinated with the Measles, Mumps, and Rubella (MMR) vaccine. Children are recommended to get two doses of the MMR vaccine, one between 12 and 15 months and the second between 4 and 6 years. One dose of MMR vaccine is estimated to be 93 percent effective against measles, while two doses are 97 percent effective.

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Health officials in Texas are battling a growing measles outbreak in an area that has some of the state's lowest vaccination rates and highest non-medical exemptions.

On January 30, officials reported two measles cases in unvaccinated, school-age children in Gaines County, which sits at the border of New Mexico and is around 90 miles southwest of Lubbock, Texas. Both children were hospitalized in Lubbock and had been discharged.

As of midday February 7, the outbreak total reached nine confirmed measles cases in the South Plains Public Health District (SPPHD) that includes Gaines, according to Zach Holbrooks, executive director for SSPHD. In an interview with Ars, Holbrooks reported that there were three additional probable cases that are linked to the confirmed cases. These are cases in the same household or family—maybe a cousin or sibling—that are showing measles symptoms but haven't been tested yet or gotten their test results back yet, Holbrooks said. So far, there have been no other reports of hospitalizations besides those in the first two cases.

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As federal lawmakers prepare to decide whether anti-vaccine advocate Robert F. Kennedy Jr. should be the next secretary of the Department of Health and Human Services, pediatricians from around the country are making emotional pleas to protect and support lifesaving immunizations.

The American Academy of Pediatrics (AAP) has assembled nearly 200 stories and dozens of testimonials on the horrors of vaccine-preventable deaths and illnesses that pediatricians have encountered over their careers. The testimonials have been shared with two Senate committees that will hold hearings later this week: the Senate Committee on Finance and the Senate Committee on Health, Education, Labor, and Pensions (HELP).

“I remember that baby’s face to this day”

In a statement on Monday, AAP President Susan Kressly noted that the stories come from a wide range of pediatricians—from rural to urban and from small practices to large institutions. Some have recalled stories of patients who became ill with devastating diseases before vaccines were available to prevent them, while others shared more recent experiences as vaccine misinformation spread and vaccination rates slipped.

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