Aug. 22 -- After a measles outbreak in Texas and 31 confirmed cases in Montana this year, public health officials are preparing for a back-to-school season that could potentially see the spread of the contagious disease.
A respiratory disease caused by a virus, measles is one of the most contagious of all infectious diseases, according to the Montana health officials. It affects up to 90% of unprotected people with close exposure to an infected person.
While death rates have fallen worldwide as more children receive the measles vaccine, the virus still kills one to three out of every 1,000 children who become infected with it due to respiratory and neurological complications.
As of Aug. 20, the 31 confirmed cases in Montana had resulted in two hospitalizations. While the bulk of the cases were in Gallatin County, two were in Flathead County. A new case popped up earlier this week in Lewis and Clark County.
The cases that popped up this year are the first in Montana since 1990.
Nationwide, there have been 1,375 confirmed cases this year with about 13% resulting in hospitalization. Three of those cases resulted in death.
During an Aug. 19 panel, public health officials and members of the Montana Public Health Training Center at the University of Montana fielded questions about the virus through the lens of the fast-approaching school year.
"Many of us have never known anyone with measles or seen anyone who has it," said Brooke Krininger, public health coordinator for Missoula Public Schools, during the panel discussion. "... And it could spread rapidly through an unvaccinated population."
To achieve herd immunity, around 95% of a population needs to be vaccinated, she said. But there has been a decline in the rate of vaccination nationwide and in Montana over the last few years.
In 2023, the national average for children under 24 months with one dose of the measles, mumps and rubella vaccine was 90.6%, according to the National Immunization Survey. In Montana, that number was 86%.
The Flathead Valley is not at herd immunity, Logan Health pediatrician Ken Graham told the Inter Lake earlier this year.
While cases may be inevitable, the goal is to keep the numbers small, according to Erin Ritchie, a registered nurse in school and day care nursing with the Jefferson County Public Health Department. Ahead of the school year, Ritchie said the most important thing a school, day care or institution can do is plan.
"It takes a village, but we do better working together," she said.
Strengthening lines of communication between agencies is essential, said Lauren Parri, a communicable disease specialist with the Gallatin County Health Department. Counties need to be prepared for measles to enter a school community and building relationships between key partners is one way to get ahead of it, she said.
That includes local health departments, schools, referral services, local clinics and hospitals.
"The goal is to have a clear sense of risk ahead of time," Parri said.
In June, Flathead County health officials stated they were keeping a close eye on the disease in anticipation of the start of school.
"In the instance of a measles outbreak, our staff would follow disease-specific guidance, investigation procedures, and mitigation protocols tailored to measles," said Lisa Dennison, the county's population health manager, at the time.
Ahead of the school year, panelists encouraged families, schools, day cares and employers to get to know the people around them and their immunity and vaccination status. That way, if an outbreak were to occur, officials would know who is most at risk.
"There's a lot of fear ... because of what we just went through five years ago," Ritchie said, referring to the Covid-19 pandemic. "... But what we're experiencing now is very different than what we experienced [then]."
For those concerned about the virus, officials recommend they stay aware of their surroundings and isolate if they experience any symptoms. Those include a fever, dry cough, runny nose and red, watery eyes. About two weeks after first contact with the disease, it's common to see a rash that starts on the face or neck and spreads down the body.
The University of Montana has also created a video series answering basic questions about measles as well as how to prepare for a potential outbreak. To view the videos or learn more, visit umt.edu/mt-public-health-training/trainings/measles-2025.php.