CDC Warns of Underreported Measles Cases Amid Ongoing Outbreak

According to Dr. David Sugerman, a senior scientist for the CDC’s measles response, there is a substantial level of underreporting regarding the current measles outbreak. Speaking at a recent meeting of the CDC's Advisory Committee on Immunization Practices, he noted that the agency is struggling to meet the increased demand for support from state health departments, particularly due to the record levels of measles reported this year, with more than 700 cases nationally—560 of which are in Texas alone.

Sugerman highlighted anecdotal evidence from families in Texas who mentioned previously untested cases, reinforcing the suspicion that many infections have gone unnoticed and untreated. The outbreak has been linked to three deaths—two unvaccinated children in Texas and an unvaccinated adult in New Mexico—which raises alarms about the broader implications of the outbreak, as these fatalities exceed what is typically expected from measles.

The outbreak primarily affects a local Mennonite community in West Texas, a close-knit group that may underutilize medical services. Sugerman stated that health officials believe there is a lack of testing and diagnosis within these communities, which contributes to the underreporting. A recent analysis indicated a higher-than-normal fatality rate from the outbreak compared to the established rates of measles infections.

In response to the crisis, Texas has redirected resources from other health initiatives to tackle the outbreak, while the CDC is working hard to find additional personnel and resources to assist Texas and other areas. This follows a series of layoffs at the CDC that have hampered its operational capabilities, particularly those related to infectious disease outbreaks.

To enhance the measles response, the CDC is considering the use of wastewater surveillance for detecting the virus's presence, drawing on methods implemented during the COVID-19 pandemic. Officials are increasingly concerned that failure to control the current outbreaks could lead to the U.S. losing its designation of having eliminated endemic measles, with significant implications for public health.

While the risks of measles to pregnant women and infants have been acknowledged, there have not been any stillbirths or miscarriages reported in this outbreak. However, health officials remain vigilant for complications that may arise in hospitals when exposed pregnant women seek care, and a recent case of congenital measles from mother to newborn has been noted, with the child recovering.