(LUBBOCK, Texas) — When the first measles cases were confirmed in western Texas, health officials said the infections primarily affected the Mennonite community.
Mennonites, who are part of the Anabaptist Christian church, have a small presence in the United States — and Texas in general — but they have a large presence in the South Plains region the state, and in Gaines County, which is the epicenter of the outbreak.
Many Mennonite communities are close-knit and under-vaccinated, which may have contributed to the spread of measles among members of the community.
But health officials are starting to see cases spread beyond the Mennonite population.
It is spreading beyond this community, “unfortunately,” Katherine Wells, director of public health for the city of Lubbock — which is located in western Texas — told ABC News. “West Texas is where the spread of these cases are right now, and we need to make sure that everybody in West Texas is getting vaccinated and is aware of measles and understands the precautions that we need to take.”
The outbreak in western Texas is continuing to grow with a total of 327 cases in at least 15 counties, according to new data published Tuesday.
Nearly all of the cases are in unvaccinated individuals or in individuals whose vaccination status is unknown, according to the Texas Department of State Health Services. At least 40 people have been hospitalized so far.
Just two cases have occurred in people fully vaccinated with the measles, mumps, rubella vaccine, according to the data.
Wells acknowledged that it may be easy for people to assume measles is only affecting a small and insular group like Mennonites and that nobody else is at risk.
“West Texas, you might say we’re small and insular compared to Dallas and some other areas,” she said. “But no, this has, unfortunately, moved into many, many different populations.”
“So unfortunately, it is growing and continues to grow,” she continued.
Marlen Ramirez, a community health worker and program coordinator at Vaccinate Your Family, which is an advocacy group based in Eagle Pass, Texas, shared a statement with ABC News, saying, “As a Community Health Worker living and working in a rural border town, I see firsthand how quickly diseases like measles can spread when vaccination rates are low and access to care is limited.”
“While the initial measles outbreak in western Texas affected members of the Mennonite community, the virus easily spreads wherever communities are under-vaccinated—and right now, we’re seeing cases reach into rural parts of Texas, New Mexico, and Kansas,” Ramirez added.
“In many of these areas, vaccination rates are below 90%, well below the 92-94% needed for community or “herd” immunity. That’s what has allowed this outbreak to grow to over 300 cases so quickly. We fear the number of actual cases may be much higher than reported due to confusion and delays in the outbreak response,” she said.
A spokesperson for DSHS confirmed to ABC News that the first cases in the outbreak were among Mennonite community members, but this is no longer the case.
“Since 90% of unvaccinated people exposed to the measles virus will become ill, there are many cases in people who are not part of the Mennonite community,” the spokesperson said. “We do not ask a person’s religious affiliation as part of our case investigation process, so we have no way of counting how many cases are part of the Mennonite community and how many are not.”
Why the Mennonite population was hit hard by measles cases
Steven Nolt, professor of history and Anabaptist studies at Elizabethtown College in Pennsylvania, told ABC News that culturally conservative and Old Order Mennonites have traditionally been under-immunized or partially immunized.
He said there are no religious teachings or bodies of religious writings that prevent Mennonites from being vaccinated. The DSHS spokesperson also added that that Mennonite religion is not “widely against vaccination.”
“Reasons are not religious but reflect everything from less frequent engagement with health care systems (for those who are more rural) to a traditional outlook that replicates practices of parents and grandparents more than the most current practices,” Nolt said via email.
For example, culturally traditional Mennonites may have participated in mid-20th century vaccination campaigns against diseases like smallpox, leading to their children and grandchildren trusting those vaccines compared to more recent additions to the immunization schedule, Nott said.
He added that Mennonites may also be influenced by the opinions of their neighbors, which may play a role in lack of vaccination.
Nolt also explained that the Mennonites who live in Seminole, Texas, a city at the center of Gaines County — a community known as Low German Mennonites, due to the language they speak — “lived in relative isolation in Mexico from the 1920s to the 1980s.”
“They missed out on the mid-century public health immunization campaigns in the U.S., be they polio or smallpox or whatever (the Mexican government had a reputation for not engaging with the Low German Mennonites at all),” he wrote. “Thus, they are starting from a different place than other culturally conservative Mennonites whose ancestors have been here since the 1700s.”
Nott went on, “My point is, the so-called Low German Mennonites from Mexico, now in west Texas, don’t have that minimum baseline of mid-20th century vaccine acceptance that we see among Old Order Mennonites and Amish in the U.S. because the folks in Seminole missed the whole mid-century immunization push, as they weren’t in the U.S. at that time.”
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