In a hard-to-watch video, a healthy-looking 4-year-old boy lies on a bed as doctors lift his eyelids to watch his big brown eyes erratically swirl and roll backward. His head jerks, and his little limbs weakly twitch and spasm. A small bit of foam pushes past his lips.

The video, captured by neurologists in India and published today in JAMA Neurology, shows what it looks like when the measles virus is allowed to ravage a child's brain. (The video can be viewed here.)

The boy was never vaccinated and developed a rare complication from measles called subacute sclerosing panencephalitis (SSPE). The condition occurs when the measles virus quietly sneaks into the central nervous system. It often lurks for years after an initial infection before it begins wreaking havoc, triggering damaging inflammation, destroying neurons, and causing brain lesions.

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As of Friday, April 25, the US has confirmed over 900 measles cases since the start of the year. The cases are across 29 states, but most are in or near Texas, where a massive outbreak continues to mushroom in close-knit, undervaccinated communities.

On April 24, the Centers for Disease Control and Prevention had tallied 884 cases across the country. Today, the Texas health department updated its outbreak total, adding 22 cases to its last count from Tuesday. That brings the national total to at least 906 confirmed cases. Most of the cases are in unvaccinated children and teens.

Overall, Texas has identified 664 cases since late January. Of those, 64 patients have been hospitalized, and two unvaccinated school-aged children with no underlying medical conditions have died of the disease. An unvaccinated adult in New Mexico also died from the infection, bringing this year's measles death toll to three.

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Even if measles vaccination rates stay the same, there could still be over 850,000 cases according to new research.

In now-rarified comments from experts at the Centers for Disease Control and Prevention, an agency official on Tuesday evening said the explosive measles outbreak mushrooming out of West Texas will require "significant financial resources" to control and that the agency is already struggling to keep up.

"We are scrapping to find the resources and personnel needed to provide support to Texas and other jurisdictions," said David Sugerman, the CDC's lead on its measles team. The agency has been devastated by brutal cuts to CDC staff and funding, including a clawback of more than $11 billion in public health funds that largely went to state health departments.

Sugerman noted that the response to measles outbreaks is generally expensive. "The estimates are that each measles case can be $30,000 to $50,000 for public health response work—and that adds up quite quickly." The costs go to various responses, including on-the-ground response teams, vaccine doses and vaccination clinics, case reporting, contact tracing, mitigation plans, infection prevention, data systems, and other technical assistance to state health departments.

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© Getty | Jan Sonnenmair

With measles declared eliminated from the US in 2000 and national herd immunity strong, health experts have recommended that American children get two doses of the Measles, Mumps, and Rubella (MMR) vaccine—the first between the ages of 12 and 15 months and the second between the ages of 4 and 6 years, before they start school.

Before 12 months, vulnerable infants in the US have been protected in part by maternal antibodies early in infancy as well as the immunity of the people surrounding them. But if they travel to a place where population immunity is unreliable, experts recommend that infants ages 6 to 11 months get an early dose—then follow it up with the standard two doses at the standard times, bringing the total to three doses.

The reason they would need three—and the reason experts typically recommend waiting until 12 months—is because the maternal antibodies infants carry can interfere with the vaccine response, preventing the immune system from mounting long-lasting protection. Still, the early dose provides boosted protection in that 6-to-11-month interval.

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Two people in Oklahoma have likely contracted measles infections linked to a mushrooming outbreak that began in West Texas, which has now risen to at least 258 cases since late January.

On Tuesday, Oklahoma's health department reported that two people had "exposure associated with the Texas and New Mexico outbreak" and then reported symptoms consistent with measles. They're currently being reported as probable cases because testing hasn't confirmed the infections.

There was no information about the ages, vaccination status, or location of the two cases. The health department said that the people stayed home in quarantine after realizing they had been exposed. In response to local media, a health department spokesperson said it was withholding further information because "these cases don’t pose a public health risk and to protect patient privacy."

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The measles outbreak in West Texas and New Mexico has reached 208 cases.

Texas officials reported 198 confirmed cases across nine counties as of Friday, with 23 people requiring hospitalization since the outbreak exploded at the end of January. Most of the cases continue to be in children and teens, with 153 of the 198 cases being between the ages of 0 and 17. Eleven cases have no confirmed age listed. All but five cases are in people who are unvaccinated or have no vaccination record.

Texas officials have so far reported one death in the outbreak in an unvaccinated school-age child with no underlying health conditions. Media reports have identified the child as being a 6-year-old.

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12 U.S. states now have confirmed measles cases.

A Texas health authority is warning against "measles parties" as the outbreak in West Texas grew to at least 146 cases, with 20 hospitalized and one unvaccinated school-age child dead. The outbreak continues to mainly be in unvaccinated children.

In a press briefing hosted by the city of Lubbock, Texas, on Friday, Ron Cook, chief health officer at the Texas Tech University Health Sciences Center in Lubbock, offered the stark warning for Texans in his opening statements.

"What I want you to hear is: It's not good to go have measles parties because what may happen is—we can't predict who's going to do poorly with measles, be hospitalized, potentially get pneumonia or encephalitis and or pass away from this," Cook said. "So that's a foolish idea to go have a measles party. The best thing to do is make sure that you're well-vaccinated."

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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 kindergartners 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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As prominent anti-vaccine advocate Robert F. Kennedy Jr. was confirmed to the nation's top health position Thursday, Louisiana Surgeon General Ralph Abraham sent a memo to the state's health department saying that the state "will no longer promote mass vaccination" and barred staff from running seasonal vaccine campaigns, according to a report by the Times-Picayune of New Orleans.

The memo echoes directives that state health employees say they were told in October and November. In meetings at the time, employees learned of a policy shift that would end seasonal campaigns for flu, COVID-19, and mpox vaccines, but it was to be implemented discreetly and not put in writing.

According to Abraham's memo, the abandonment of lifesaving vaccination campaigns is in service of individual choice. "For many illnesses, vaccines are one tool in the toolbox of ways to combat severe illness," according to The New York Times, which also obtained a copy of the memo.

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The US Senate on Thursday confirmed the long-time anti-vaccine advocate Robert F. Kennedy Jr. as Secretary of Health and Human Services.

The vote was largely along party lines, with a tally of 52 to 48. Sen. Mitch McConnell (R–Ky.), a polio survivor and steadfast supporter of vaccines, voted against the confirmation, the only Republican to do so.

Before the vote, Minority Leader Charles Schumer (D–N.Y.) claimed that if there had been a secret ballot today, most Republicans would have voted against Kennedy. "But sadly, and unfortunately for America, Republicans are being strong-armed by Donald Trump and will end up holding their nose and voting to confirm Mr. Kennedy... What a travesty," Schumer said.

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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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Flu season is ramping up across the US, but Louisiana—the state that has reportedly barred its health department from promoting flu shots, as well as COVID-19 and mpox vaccines—is leading the country with an early and strong surge.

Louisiana's flu activity has reached the "Very High" category set by the Centers for Disease Control and Prevention, according to the latest data. The 13-category scale is based on the percentage of doctor's visits that were for influenza-like illnesses (ILIs) in the previous week. Louisiana is at the first of three "Very High" levels. Oregon is the only other state to have reached this level. The rest of the country spans the scale, with 13 jurisdictions at "High," including New York City and Washington, DC. There are 11 at "Moderate," 10 at "Low," and 19 at "Minimal."

Map of ILI activity by state Credit: CDC

Last week, NPR, KFF Health News, and New Orleans Public Radio WWNO reported that the state had forbidden the health department and its workers from promoting annual flu shots, as well as vaccines for COVID-19 and mpox. The policy was explicitly kept quiet and officials have avoided putting it in writing.

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