The Texas measles outbreak has now infected a total of 561 people since January, including 20 new cases confirmed since last Friday.

The Texas Department of State Health Services said “fewer than 25 of the confirmed cases” are believed to be actively infectious as of Tuesday, April 15, based on when their rashes appeared. The counties with “ongoing measles transmission” are Cochran, Dallam, Dawson, Gaines, Garza, Lynn, Lamar, Lubbock, Terry and Yoakum.

The Metroplex has continued to avoid any known infections, despite some exposures to contagious people. The vast majority of Texas’ confirmed infections are in the South Plains and Panhandle regions of western Texas. A person who contracts measles is infectious four days before a rash appears, and four days after.

Of the 561 measles patients, 58 have had to be hospitalized. Two school-age children have died in the Lubbock area.

All but 11 of the outbreak cases were in unvaccinated people, mostly children.

Tarrant County remains on alert after someone with measles visited Grapevine in late March. The window for any known infections from that exposure is closing. Anyone who was at Great Wolf Lodge hotel and waterpark between March 28 and 30, or Grapevine Mills Mall on March 29, should watch for symptoms through April 20.

An 8-year-old girl died April 3 from measles pulmonary failure at a hospital in Lubbock. The first child died in Lubbock in February. A man in New Mexico also has died after contracting measles.

Signs and symptoms of measles

It can take seven to 14 days for symptoms to start showing if you have measles:

• High fever
• Cough
• Runny nose
• Red, watery eyes (conjunctivitis)

After two or three days, white Koplik spots might start appearing inside your mouth. Three to five days after symptoms, the measles rash appears, possibly with high fever above 104 degrees. The rash often starts out as flat red spots on the face around the hairline. The rash spreads down to the neck, torso, arms, legs and feet.

Small bumps may appear on top of the flat red spots. As the rash spreads, the spots can merge together from the head to the rest of the body.

Severe complications:

• Hospitalization in about 1 in 5 unvaccinated people.
• Pneumonia in 1 out of every 20 children. It is the most common cause of death from measles in young children. An 8-year-old girl who died April 3 in a Lubbock hospital suffered from measles pulmonary failure.
• Encephalitis, or swelling of the brain, in 1 out of 1,000 children. This can lead to convulsions and leave the child deaf or with intellectual disability.
• Nearly 1 to 3 of every 1,000 children who become infected with measles will die from respiratory and neurologic complications.

This story was originally published April 15, 2025 at 3:24 PM.

Matt Leclercq

Fort Worth Star-Telegram

Matt Leclercq is senior managing editor at the Fort Worth Star-Telegram. He previously was an editor at USA Today in Washington, national news editor at Gatehouse Media in Austin, and executive editor of The Fayetteville (NC) Observer. He’s a New Orleans native.