Measles outbreak grows, hantavirus, Medicaid popularity, and opioid and HPV deaths decline
The Dose (March 10)
Good morning! Hope you had an easier time adjusting to the time change than I did—toddlers don’t exactly respect daylight saving time.
Here is your week’s public health news you can use.
Measles marches on, facing two major challenges
The measles outbreak in West Texas is growing.
This is the most contagious virus, making any public health response resource-heavy. But two obstacles are making this outbreak particularly challenging:
1. The true number of cases is unclear
The official count is 228 cases across 10 counties. (Note: New Mexico’s measles outbreak—30 cases, 1 death—is now genetically linked to Texas, meaning these two outbreaks are one, so I will combine them from here on out.)
It’s very hard to say whether we are at the beginning or middle of the outbreak, mostly because I don’t trust the numbers. Several signs suggest substantial underreporting:
Death ratio. We’ve seen two deaths so far, yet only 228 cases have been reported. Measles typically kills 1 in 1,000 unvaccinated individuals. They were either extremely unlucky, or there are more cases than reported.
Very sick hospitalized patients. By the time these hospitalized children get to the hospital, they are very sick, meaning parents may be delaying care. The second measles fatality (which was an unvaccinated adult) never even went to the hospital.
Epidemiologists are encountering resistance to case investigations.
We don’t just have a murky numerator (case count)—we also have a murky denominator (population size). The community at the center of this outbreak is likely far larger than official U.S. Census figures suggest.
I wager the “true” count is much higher than reported. A CDC response team is now on the ground, working directly with local and state epidemiologists to help get this under control.
2. First taste of RFK Jr. and falsehoods
When an unfamiliar epidemiologist with a clipboard parachutes into a community, their impact is often limited because trust takes time to build. Effective outbreak response depends on local partnership—especially with trusted messengers. But in West Texas, some of the most trusted voices are actively working against public health:
Some local physicians are pushing unproven treatments—like budesonide, vitamin A, and cod liver oil—as substitutes for vaccination. Bulk shipments of these false remedies are being flown in.
Some pastors are celebrating low vaccination rates, including T-shirts bragging about being the “least vaccinated county.”
Messages are making their way into Secretary Kennedy’s talking points, including a Fox News segment, a recent op-ed, and his anti-vaccine nonprofit, Children’s Health Defense.
Falsehoods aren’t just a nuisance—they have real consequences. People may experience short-term symptom relief that masks a severe infection, delaying life-saving care. This has already happened at least once in this outbreak. There’s also growing concern about them poisoning themselves due to overdosing on vitamin A.
What does this measles outbreak mean to you? There are a few things to do if you’re in the hot zone, like children as young as 6 months old getting vaccinated and paying attention to exposures. If you’re traveling here for spring break, I would reassess, especially if you have an unvaccinated or immunocompromised family member.
Your national disease report: Illnesses are nosediving
Good news: we’re getting a break from “influenza-like illnesses” (fever, cough, sore throat), which continue to nosedive—typical as the weather warms up and we head into the spring months.
What does this mean to you? Flu is still around, but the worst of the season is behind us. If you haven’t gotten your flu shot yet, it’s probably not worth getting at this point. Chat with your doctor.
Other virus activity in the past week
There are more measles cases from international travel, and H5N1 keeps showing its teeth, as more backyard flocks and housecats are infected. Due to an infected cat, we also have a rabies alert in Volusia County, Florida.
What does this mean to you?
For rabies prevention, avoid physical contact with wild animals. Here are the high risk locations for Floridians.
For H5N1, the advice for backyard folks and cat owners stays the same. For cat owners, ensure your cat drinks no raw milk and limits exposure to wild animals and birds.
Opioid deaths drop 24% and data challenges loom
New CDC data shows opioid overdose deaths have dropped to 87,000 annually—the lowest since 2020. The drop is due to a return to normal for substance use prevention and treatment services that were stalled during the pandemic. There’s also been marked improvement in access to substance use treatment and naloxone. Naloxone (name brand Narcan) is a life-saving medication that can reverse an overdose.
Data continuity is key to tracking progress. The new administration recently called for more data for another goal: to keep Canada and Mexico tariffs at bay. In February, the administration agreed to delay tariffs on those countries when they confirmed they’d help prevent fentanyl from entering the U.S. However, tracking this in real time is a big data challenge for a few reasons:
Overdose deaths are already declining, making it hard to measure policy impact. Fewer deaths doesn’t necessarily mean less fentanyl; it could just mean better treatment and response.
No real-time fentanyl death data exists—current numbers lag by months.
Fentanyl can enter the drug supply through many channels. (Canada plays virtually no role in the U.S. fentanyl influx, for example).
What does this mean to you? Although decreasing, opioids are still the leading cause of death for Americans aged 18-44. Narcan is available over the counter, carried by EMS providers, and even stashed in vending machines in some places, like New York City.
Cervical precancer drops 80%
Data on the effectiveness of the HPV vaccine against cancer is continuing to pour in. The latest is from the Human Papillomavirus Vaccine Impact Monitoring Project (HPV-IMPACT), which surveys people across the U.S. From 2008-2022, cervical precancer rates dropped by a whopping 80% among women aged 20-24. As a comparison point, precancers decreased by 37% in the 25-29 age group, who were more likely to contract HPV pre-vaccination.
HPV vaccines are recommended as part of routine vaccination for all genders at age 11 or 12, with catch-up vaccination up through age 26 (but you can still receive the vaccine until age 45).
What does this mean to you? If you or your child haven’t gotten the HPV vaccine yet, ask your healthcare provider. It does not affect fertility, despite false rumors. Read more in the PDF below (see #11).
The majority of Americans support Medicaid
A new KFF poll last week found that 80% of Americans oppose cuts to Medicaid. About one-third of Republican voters supported cuts, and over half of all respondents—especially in rural areas—said they or someone they know has used Medicaid.
Medicaid programs go by different names in each state, making it tricky to track how federal changes might affect your health care. For example, “cutting Medicaid” is the same as “cutting PeachCare” in Georgia or “cutting Healthy Connections” in South Carolina. Hover over the graph below to see what Medicaid is called in your state.
Question grab bag
“Not another virus. What the heck is hantavirus?”
Betsy Arakawa and Gene Hackman’s bizarre deaths have been all over the news. Her cause of death is in: hantavirus infection. While this event is tragic, it is not a major public health concern.
Hantavirus infection in humans is extremely rare, and cases are concentrated in the Western U.S. In 2024, there were only 15 reported cases in the U.S. The virus is mainly carried by desert-dwelling mice or rats, and humans can be infected by breathing in dust contaminated with their urine or droppings.
Hantavirus is not spread between humans, so the key is to avoid rodent contact, including cleaning areas with rodent activity. Before sweeping or vacuuming, spray the urine or droppings with a disinfectant solution, let them dry, and wear your trusty N95 mask.
Poll
Bottom line
You’re all caught up for the week!
Love, the YLE team
Your Local Epidemiologist (YLE) is a public health newsletter with one goal: to “translate” the ever-evolving public health science so that people feel well-equipped to make evidence-based decisions. This newsletter is free to everyone, thanks to the generous support of fellow YLE community members. To support the effort, subscribe or upgrade below:
Please continue to call out health care lies and misinformation from Kennedy and Trump.
I think the audience for this blog already knows there is zero evidence for, and lots of evidence against, any link between vaccines and autism. While I think it would be wonderful if we could convince those who distrust vaccines of their safety, we aren't the ones who can do that. I wish I knew who could.