Gaines County, Texas - A growing measles outbreak in west Texas has infected 48 people, according to official state data released Friday – the latest sign that the once-vanquished childhood disease is making a comeback as vaccination rates decline.

The outbreak comes as vocal vaccine skeptic Robert F. Kennedy Jr. – who has repeatedly and falsely linked the measles, mumps, and rubella vaccine to autism – was confirmed as the US health secretary, a position that grants him significant authority over immunization policy.

The patients are overwhelmingly children, all were either unvaccinated or had unknown vaccination status, and 13 have so far been hospitalized. Health officials expect additional cases to emerge.

Childhood vaccination rates have been declining across the US, a trend that accelerated during the Covid-19 pandemic, when concerns over the rapid deployment of mRNA vaccines, coupled with mountains of misinformation, further eroded trust in public health institutions.

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"There are pockets in the US that are susceptible, and it's not surprising to me that it's occurring in a county where there are the lowest rates of vaccination in the state – these are kindling for such outbreaks," Amesh Adalja, a senior scholar at Johns Hopkins University, told AFP.

The bulk of the cases occurred in Gaines County, which reportedly has a high rate of exemptions to vaccines – often granted on religious grounds.

Nationwide, vaccination coverage among kindergarteners dropped below 93% during the 2023–24 school year, remaining under the federal target of 95% for a fourth consecutive year, according to the Centers for Disease Control and Prevention (CDC).

The US reported 285 measles cases last year, per the CDC. The worst recent outbreak was in 2019, when 1,274 cases – largely concentrated in Orthodox Jewish communities in New York and New Jersey – drove the highest national total in decades.

Measles is a highly contagious respiratory illness best known for its rash, but it can also cause pneumonia, brain infections, and other severe complications.

It remains a major global killer, claiming tens of thousands of lives each year.

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"It really is mind-boggling that people in the United States have decided not to take this vaccine," Adalja said.

"When you think about infectious disease, there should be steady progress to make it less and less of an issue. But what we see in the case of measles is that it's see-sawing."

Kennedy's confirmation as health secretary has alarmed many in the medical community, including Adalja.

"Measles and RFK Jr. go together," he said.

"When you have the chief propagandist for the anti-vaccine movement in the highest position of government power when it comes to health, the only thing that benefits from that is measles."