The Texas Department of State Health Services released its latest measles count Tuesday: 163 cases with 22 of those needing hospitalization. On Friday, there were 146 cases in the state.

The count includes only one death, a school-age child in Gaines County. Most of the cases, 159, are in West Texas.

On Friday, Travis County had its first measles case since 2019, an Austin infant, who was noted in an Austin Public Health news conference. That child was too young to be vaccinated and had traveled outside the U.S. when they became exposed. The infant’s family were all vaccinated and are quarantining to prevent spreading the disease.

Measles is a concern because 90% of people exposed to the virus who have not been vaccinated or do not have natural immunity will become infected after being exposed. It is one of the most infectious diseases.

The virus can live on the surfaces of a room for two hours after the exposure.

Most of the cases are in and around Gaines County in West Texas, not far from Lubbock and the Panhandle, but the state issued a warning for people in San Marcos, New Braunfels and San Antonio about a possible exposure after a person who later tested positive for measles traveled to Central Texas on Feb. 14-16.

The measles infection of the Austin infant is not related to the person who traveled to Central Texas from West Texas.

Most people don’t know they are infected with measles before they have infected someone else, said Dr. Rama Thyagarajan, an infectious disease expert and an associate professor at the University of Texas Dell Medical School. The disease is not something primary care doctors are used to screening for or suspecting as a possible cause for the flu-like symptoms that begin a measles case, she said.

“It is always a good idea with any respiratory illness to stay home,” Thyagarajan said.

What are the symptoms of measles?

After seven to 14 days of being exposed, measles starts with:

• Cough
• Runny nose
• Conjunctivitis
• Usually a fever of 103 to 104

Four days later:

• A rash starting at the head and working its way down the body appears.
• The rash can start as sore spots in the mouth.

In severe cases:

• Inflammation of the lungs
• Pneumonia from a secondary infection
• Inflammation of the brain

Years later:

In some rare cases, measles can cause a fatal form of encephalitis, swelling in the brain, years after being infected.

How long are you contagious with measles?

People with measles are infectious four days before the rash starts and then four full days after the rash begins. They should isolate an additional 10 days.

If you have been exposed and have symptoms, you should call your doctor first instead of showing up at an emergency room or doctor’s office.

When can I get a measles vaccination?

The measles vaccine is known as the MMR vaccine: measles, mumps and rubella (the latter is also known as German measles). It is a live vaccine and should not be given to pregnant women and some people with autoimmune issues, including some people who are undergoing treatment for cancer.

Most children are vaccinated with the first dose when they turn 1. A second dose is given between ages 4 and 6. A second dose can be given as soon as 28 days after the first dose.

A first dose of the vaccine can start giving someone some protection within 72 hours and can be used to fight a measles exposure. A first dose provides about 93% protection after two weeks. After the second dose, a person has 97% protection.

For people who have been exposed, they can receive immunoglobulin within six days of an exposure to fight the virus.

What happens with babies who are not old enough for the vaccine?

In some cases, you can give the vaccine to infants who are 6 months or older, especially if they have been exposed. Health officials have not made that recommendation for all infants 6 months or older, yet, said Dr. Desmar Walkes, the Austin-Travis County public health authority, but that recommendation might change if Austin does experience an outbreak.

If you do get your 6- to 11-month-old vaccinated, they would need a second shot at age 1 and then a third shot at age 4.

Infants who have not been vaccinated need to be kept away from exposure in an outbreak, and the people around them should be vaccinated, Thyagarajan said. The same is true for anyone who cannot receive the vaccine because of health conditions such as cancer treatments or an organ transplant.

How do I know if I have immunity?

People who were born before 1957 are presumed to have immunity because of the amount of measles that was present during that time. People born after that time need to make sure they have been vaccinated with two doses. If you were born between 1957 and 1968, you might not have immunity because the vaccine at the time didn’t use a live virus.

Vaccine protection does wane over time. You can get a blood test to check your immunity level to be sure. If you have been pregnant in the last 30 years, you have already had your titer check for rubella, which is in the MMR vaccine and would have been told if you did not have immunity.

How can I get vaccinated?

For vaccinations, contact your primary care provider or you can go through Austin Public Health. You can get vaccinated as an adult if you have not been vaccinated previously.

Austin Public Health offers vaccinations for free or at reduced rates for children and adults who do not have insurance, have Medicaid or are underinsured. The typical cost is $13 for children and $25 for adults. You can make an appointment at 512-972-5520 for either of the clinics at 405 W. Stassney Lane in South Austin or the 7500 Blessing Ave. location in Northeast Austin.