The number of confirmed measles cases in Texas tied to the outbreak that started in January has risen to 624 as of Tuesday, April 22, which is an increase of 27 since last week.

The Texas Department of State Health Services said “fewer than 10 of the confirmed cases” are believed to be actively infectious since their rashes appeared less than a week ago. People are infectious four days prior to and four days after rash onset.

As of Tuesday, state officials have not confirmed any measles cases in the Metroplex, despite multiple occasions when people who were infectious exposed others in public in recent weeks. The window for illness after measles exposure in Grapevine in late March has ended.

But last week, Collin County health officials said someone who spent time in Plano on April 10 and 11 later tested positive for the highly contagious virus. The person went to a Walmart, Ross Dress For Less and Dollar Tree; anyone who is not vaccinated against measles may be at risk of contracting it.

Since January, 64 people have been hospitalized for measles and two unvaccinated children have died.

The outbreak began in the South Plains region of western Texas and has largely been contained there, but there’s a high risk of measles spreading elsewhere, especially in counties where vaccination rates among children are below 95%, including Tarrant.

Signs and symptoms of measles

Measles lives in the nose and throat, and it spreads through coughing and sneezing. You can get measles by breathing contaminated air or touching an infected surface.

Measles symptoms typically begin with:

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

2 or 3 days after measles symptoms begin:

Koplik spots, which are tiny white spots, might start appearing inside your mouth.

3 to 5 days after measles symptoms begin:

Now you start to see the measles rash, and fever may spike 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.

On Tuesday, April 15, the Rockwall County Health Authority, east of Dallas, said someone who had traveled to West Texas had tested positive for measles. Rockwall County is not included in the state’s most recent list of cases confirmed to be part of the outbreak, published Friday morning. It may be that authorities haven’t confirmed whether the infection is part of the outbreak. Rockwall County had another measles case in February of an unvaccinated person who had recently traveled abroad.

This story was originally published April 22, 2025 at 12:02 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.