As the Trump administration dismantles international public health protection measures, withdraws funds from local health departments and moves to justify health misinformation, some experts fear the country is setting the stage for a long-term measles revival.
If federal health officials don't change courses, a massive outbreak like the one that tore West Texas and jumped into a nearby state and killed two people could become the norm.
“It really opened the door for this virus to come back,” said Dr. Thomas R. Frieden, former director of the Centers for Disease Control and Prevention.
In order for the virus to occur in the US, it must first be imported into the country, reaching a large, unvaccinated population.
Dr. William Moss, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, said recent events seem to make both conditions more and more possible.
Efforts to control the spread of measles internationally have been disrupted by the Trump administration's recent decision to withdraw from the World Health Organization, which operates a network of more than 700 labs tracking measles cases in 164 countries.
The program will help ensure a rapid public health response to new outbreaks, but it relies on the US to fund an entire $8 million annual budget.
Gavi's funds were not included in the list the State Department sent to Congress last week for programs they would continue to seek support. However, the organization has not yet received a formal grant termination letter, and its leadership is lobbying the administration to maintain its funds.
Both the WHO withdrawal and the possibility of loss of Gavi's funds are likely to cause a surge in measles incidents overseas, increasing the likelihood that US travelers will return the virus to the country, said Dr. Walter Orenstein, professor emeritus at Emory University and former director of the CDC's National Immunological Immunity Program.
“People don't realize that helping with global vaccinations is good not only for their own country, but for our country,” he said.
This week's layoffs at the CDC included staff members who communicate with the public during the outbreak of infectious diseases, helping to create a campaign to promote vaccination.
Communications will now be centralized at the Department of Health and Human Services under the supervision of vaccine skeptic Robert F. Kennedy Jr. The department did not respond to requests for comment.
Former CDC Director Dr. Frieden described the cut as a “disaster recipe.”
National vaccination rates for measles that have fallen during the Covid-19 pandemic have not rebounded against the 95% needed to stem the spread of the virus in communities. It increases the probability that imported cases will land and fire in vulnerable groups.
Approximately 93% of kindergarten children shot MMRs between 2023 and 24. However, vaccination rates are distributed unevenly. Some communities have a rate of around 80%, offset by other communities whose figures are close to 99%.
Now that HHS has cut billions of dollars to local health sectors, they may struggle to counteract outbreaks early on, allowing the virus to jump on other Wakchan state communities. (The judge temporarily blocked funding cuts after the state coalition sued the Trump administration.)
During an infectious disease emergency, it is the local health department that investigates the source of the pathogen and tracks anyone who may have been exposed to be examined.
The contact tracing process is time-consuming and resource-intensive. Especially in the case of contagious viruses like measles.
“The fire is on fire and we are closing all fire stations at the same time,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University's School of Public Health.
The current outbreak, which began in West Texas, shows no signs of slowing down. There have been over 56 cases since late January, and 56 hospitalizations. The outbreak has spread to cross-border states, with 54 people in New Mexico and 10 people in Oklahoma sick.
The genetic sequence suggests that the outbreak is also linked to 24 measles cases discovered in southwestern Kansas.
Measles was officially eliminated in the US in 2000, but the rate at which the Texas outbreak grew and the fact that it already jumped to other Wakchan state communities makes it very likely that the US would lose its position, Dr. Nuzzo said.
Measles is no longer considered to be eliminated if a series of infections lasts longer than 12 months. West Texas public health officials predict that the outbreak will continue for a year.
The large measles outbreak that spreads parts of New York for nearly 12 months has cost the country almost in 2019. This outbreak was largely involved due to aggressive vaccine orders.
“We just missed it in our hair,” Dr. Nuzzo said. “The place we are at is worse than that.”
Kennedy provides calm support for vaccinations, highlighting untested treatments for measles, such as cod liver oil. According to a doctor in Texas, his support for alternative treatments has contributed to patients delaying critical care and taking toxic levels of vitamin A.
Kennedy recently tapped prominent figures in the anti-vaccine movement and worked on research examining long-lived theories that vaccines are linked to autism.
If the country loses its removal status, Dr. Moss said it is unlikely that the infection rate would be similar to that of the prevailing era when measles had infected almost every child by the age of 15.
However, it is likely to mean more frequent and greater outbreaks that increase the risk of living for the most vulnerable people in society.
“There are direct consequences – health fees, long-term health impacts,” Dr. Nuzzo said. “The occurrence of measles is incredibly expensive and destructive.”
“It's just embarrassment, too. It's about lining up the US on par with most high-income countries, as in the world's most resource-constrained environment.”
