A measles outbreak that has killed two people and infected more than 200 has broken out in the southwestern United States, prompting a leading health agency to issue a travel warning.

Texas has recorded 198 cases and New Mexico 30, bringing the total number of sickened to 228. Each state confirmed one death, both of whom had not been vaccinated.

The Texas patient was a child and the New Mexico patient was an adult who tested positive for measles postmortem.

Although the official cause of the adult's death has not been released by the New Mexico Office of the Medical Investigator, the Center for Disease Control and Prevention (CDC) has classified it as a measles-related death.

"More cases are expected as this outbreak continues to expand rapidly," the CDC warns in a Health Alert Network advisory to health care workers, public health officials and potential travelers.

"As the U.S. spring and summer travel season approaches, CDC emphasizes the important role that physicians and public health officials play in preventing the spread of measles," the agency said.

"They should be vigilant for cases of febrile rash illness that meet the measles case definition and share effective measles prevention strategies, including guidelines for vaccinating international travelers."

Measles is a highly contagious disease that is spread by respiratory droplets and lingers in the air for up to two hours after an infected person leaves the area. The disease causes fever, respiratory symptoms and rash, but can also lead to severe complications including pneumonia, brain inflammation and death.

Vaccination remains the best protection. The measles vaccine, which is mandatory for children 12 months and older, provides 93% lifetime immunity after one dose and 97% after two.

But immunization rates in the U.S. have been declining, especially since the Covid-19 pandemic fueled a wave of misinformation about vaccines.

The CDC recommends a 95 percent vaccination rate to achieve herd immunity, but by 2023-2024, coverage among kindergartners nationwide had dropped to 92.7 percent.

Religious exemptions are on the rise, and the epicenter of the epidemic is a county in West Texas with a large Mennonite religious community that has historically been indecisive about vaccines.

Current Secretary of Health Robert F. Kennedy Jr. has spent decades falsely linking the measles, mumps and rubella (MMR) vaccine to autism, a claim completely disproven by scientific research.

After the epidemic grew, he softened his stance, recommending vaccination while encouraging treatment with vitamin A and steroids.

While these treatments are medically sound, experts warn that an emphasis on them could distract from the urgent need to increase immunization rates. | BGNES