Dowse wore a full-body protective suit with a plastic face mask. As a pediatrician in southern Utah, he couldn’t risk getting even a mild infection, because many of his patients are babies too young for measles vaccines or children whose parents choose not to protect them with immunizations. “I went in looking like a scientist in E.T.,” he said.

Measles can cause brain damage, deafness, or death in newborns. If the baby entered the world with a measles rash and fever, Dowse was prepared to give the infant a spinal tap to assess the risk of neurological damage.

Luckily, flushed and crying, the baby looked healthy. To keep it that way, Dowse wanted to inject the baby with concentrated antibodies against the measles virus. To his surprise, the parents objected, promising to give their child “all kinds of vitamin A,” Dowse said. He begged them not to, saying, “You can’t see it on the surface, but the baby’s body is fighting the measles.” They were afraid of vaccines, so Dowse explained that antibodies were different and that they would stop measles from replicating in the infant.

“That shot is going to basically give the baby ammo to fight,” Dowse said.

The parents relented. A couple of days later, they left the hospital with a child who had narrowly skirted an infection that killed many thousands of babies a century ago. Nonetheless, Dowse said he doubted they would be returning for childhood vaccinations to protect their baby against a bevy of illnesses. Like more than a dozen Utah doctors and health officials who spoke with ºÚÁϳԹÏÍø News, Dowse has adjusted his expectations.

He is part of a reluctant cohort of medical professionals now on the front line of America’s regressive next chapter in health history, one in which dangerous and preventable diseases return.

“I wish that people could see what I see,” said Nathan Money, a hospital pediatrician in Utah whose eyes welled up with tears as he described children he’s treated for measles struggling to breathe. “This train is going in the wrong direction, and it can feel like a helpless situation, because we’re just not seeing the public messaging and leadership that’s needed to turn this around.”

Since measles was deemed eliminated in the U.S. a quarter century ago, public health workers have extinguished sporadic outbreaks in close-knit, undervaccinated communities with targeted methods: Isolate people with measles and quarantine their contacts to contain the virus. But as vaccination rates , the virus is moving beyond insulated communities, overwhelming public health departments constrained by shoestring budgets. Larger outbreaks, the kind not seen for a generation, have forced health officials into a new paradigm: They have stopped racing to “contain” infections and shifted gears into what they call “mitigation.”

Utah made that transition early this year, once the outbreak hit “a point where you no longer have control over it,” said state epidemiologist Leisha Nolen. By March, measles had been detected in every health jurisdiction in the state and in northern Arizona. More than 950 people have tested positive in the two states since the outbreak began in August, but many people with measles haven’t been tested. A of measles viruses suggested that the true number of cases last year could have been 6.5 times what was known.

Last year under President Donald Trump, U.S. measles cases exceeded 2,000 for the first time since 1992. Six months into 2026, the U.S. has already surpassed that threshold. Prolonged outbreaks exact a toll on children, who have spent days in hospitals for severe infections and missed weeks of school for mild ones. Adults with measles miss work. Parents delay daycare to keep their babies safe. Doctors in Utah have enacted labor-intensive protocols to keep measles from spreading in clinics. Newborns and people with weakened immune systems who have been exposed to the virus receive infusions of concentrated antibodies costing $500 to $1,000. Medical visits for measles . Health departments spend millions trying to curb infections.

“This is like a snowball that gathers speed as it rolls downhill,” said Emilie Morris, a hospital pediatrician in Salt Lake County and Utah County. A full-throttle campaign to educate communities on the safety of vaccines and the diseases they prevent could turn the situation around, doctors and health officials said. It would require an effort similar to what the anti-vaccine movement has long done in videos, blogs, and podcasts. For example, the anti-vaccine organization that Robert F. Kennedy Jr. founded before taking the helm at the Department of Health and Human Services, Children’s Health Defense, visits , , and has bought that downplay the threat of viruses while wildly exaggerating the risk of vaccine side effects. Kennedy’s and as health secretary are adding to parents’ doubt.

After the development of vaccines and antibiotics in the mid-1900s, virologist and Nobel laureate Frank Macfarlane Burnet wrote, “One can think of the middle of the twentieth century as the end of one of the most important social revolutions in history, the virtual elimination of the infectious diseases as a significant factor in social life.”

He couldn’t have imagined what was coming.

‘Year of Sickness’

In communities nestled among the red sandstone cliffs and riparian forests of southern Utah, measles took hold last summer. At the main school in Hildale, a town along the Arizona border, just 30% of kindergartners are considered adequately immunized by Utah’s health department, meaning they’ve gotten recommended vaccines against measles, tetanus, polio, and more. Exemptions from childhood vaccine requirements are easily acquired in the state: Parents need only claim personal, religious, or medical reasons.

Many people in Hildale and the surrounding towns are connected to the Fundamentalist Church of Jesus Christ of Latter-Day Saints, a sect that has been leery of the government since a police raid in 1953 separated polygamous parents from their children. Shirlee Draper, a southern Utah resident who grew up in the faith, said they became ever more isolated in the early 2000s under the leadership of Warren Jeffs. Before he was sentenced to life in prison for sexual assault against minors, Jeffs instructed his followers to withdraw from public schools and mainstream medicine.

“Growing up, we all got our vaccines,” said Draper, who left the group during Jeffs’ reign. “It wasn’t until Warren Jeffs came along that there started to be more and more resistance.”

After Jeffs went to prison, many people left the faith but remained concerned about vaccines because of online misinformation, such as claims that the shots are toxic. Today a small shop in Hildale sells mouth sprays and oral drops professing to detoxify vaccines. Water, glycerin, and “whole grain alcohol” are listed as ingredients in one called Vxx-Dtx.

A mother who ºÚÁϳԹÏÍø News agreed not to name, because she fears stigmatization, said she considered getting her kids vaccinated when schools in southwest Utah started seeing measles cases last summer. She had split from the fundamentalist group but still worried about vaccines giving her children autism or other complications. in top-tier scientific journals have refuted a link between vaccines and autism, but the anti-vaccine movement has kept the notion alive.

Then the woman’s son told her that his classmate had a rash and spit on him, she said. A few days later, he fell ill with a fever, followed by vomiting, diarrhea, and a head-to-toe rash.

“He felt downright sick for 10 to 14 days,” the woman said. “It was hard to see the end of the tunnel.”

Then her daughters came down with measles. She had a fleeting case, too, even though she had been vaccinated as a child. Breakthrough infections and are relatively rare. Only 4% of reported this year and last have been among people who’ve had two doses of the measles, mumps, and rubella vaccine.

By the time the family recovered, the son had missed nearly three weeks of school, the daughters a month, and the mother had postponed an important family gathering because she didn’t want to spread infections. “I just got my youngest’s missed-school report and it’s super high,” she said. “This is the year of sickness.”

The woman said she regretted not getting her kids vaccinated when the outbreak started. She said she knows about 30 people who have fallen sick with the measles. Except for a few who needed medical care, they haven’t been tested. “I bet there’s been thousands of cases,” she said.

Measles doesn’t have a cure. She and others have tried to ease symptoms with cod liver oil, vitamin C, zinc, and “essential oils,” plant extracts long used in folk medicine that have become a lucrative industry in Utah. People in southwest Utah are trying a lot of things: One resident sells homemade lotion on Facebook, writing, “Breastmilk & Honey has been a life saver for the measles rash.”

Beyond Containment

The outbreak may have started among a fundamentalist community, but it’s spread far beyond because Utah’s vaccination rates have dropped steadily since the covid pandemic. Fewer than 80% of kindergartners in the 2024-25 school year in southwest Utah, with only 87% adequately immunized in the state as a whole — far below the 95% threshold required for herd immunity.

Several Utahns told ºÚÁϳԹÏÍø News that “alternative health” or “wellness” drives the trend, rather than religion. The state has a thriving supplement industry, , aided by deregulatory policies supported by the late Utah senator Orrin Hatch and a high concentration of people who earn income from multilevel marketing. These networks of people sell supplements, essential oils, peptides, and other alternative therapies on social media, YouTube, and podcasts, according to and .

Alternative health isn’t necessarily anti-vaccine, but many people who sell unconventional remedies online and in podcasts and mainstream medicine.

“People are suspicious, and it’s well founded,” Draper said. She described dismissive doctors, exorbitant medical bills, hospital systems that over care, and pharmaceutical companies that drove . Communities already wary of government authorities are poised to interpret failings in American healthcare as signs that medical authorities aren’t to be trusted, either, she said.

“Across America, we have entire populations who find safety in clinging to whatever confirms their deeply held beliefs,” she said.

A mistrustful disposition gave way to covid conspiracy theories in 2020 and 2021. In southwest Utah, for example, a tricked out with digital billboards showed up to covid vaccination sites to advertise Plandemic, a rife with , including that masks “activate” the coronavirus and that global elites planned covid-19 to control the population. Misinformation added fuel to anger about public health rules, and there was political backlash under the umbrella of a largely Republican “medical freedom” movement. Utah enacted laws reining in public health, including one that eases exemptions to childhood vaccinations and another that prohibits most employers from requiring vaccines.

In the wake of the covid backlash, health officials tread lightly. Rather than enforce containment measures, “we give our advice and focus on personal responsibility,” said David Heaton, public information officer at the Southwest Utah Public Health Department.

One of the most contagious diseases in the world, measles spreads with astonishing speed among the unvaccinated. One of a New York school outbreak in 1974 found that a second-grader with measles infected 28 other students in 14 classrooms because measles can spread through ventilation systems.

As cases doubled then quadrupled in southern Utah, the regional health department couldn’t keep up with calling the contacts of everyone infected. It shifted its efforts to announcements guiding the public at large. For example, it asks people to call before showing up to clinics with measles symptoms. Still, patients in plenty of hospitals have been exposed. For example, when parents brought a sick, unvaccinated child to a large pediatric hospital in Utah in September, they shared the space with 11 infants too young to be vaccinated. Doctors rushed to give the babies infusions of antibodies and they remained healthy, according to a .

On the radio and in posts on social media, Heaton warns that measles is spreading and that vaccines are the best defense. “If you’re not immunized and you’re anywhere in public,” Heaton said, “you’re fair game for this virus.”

The department doesn’t have the capacity to talk with people directly in the five counties it serves. For a few years, it leaned on community health workers who went to churches, town halls, and other gathering places, listening to people’s concerns and telling them what the science said about covid, vaccines, and other matters of public health. But these workers were laid off early last year, after the Trump administration clawed back more than $12 billion in federal public health grants to states.

“We were starting to get a little bit of traction,” Heaton said of the community workers. “And then we lost all of our team.”

The department offers free measles vaccines to children, but uptake is slow. Nursing director Mindy Bundy said that when she started the job 20 years ago, demand was so high that she would give parents tickets while they waited, as if they were crowding around a deli counter.

“Now even in an outbreak,” she said, “we aren’t seeing a huge increase of people wanting vaccination.”

As officials tried to do the best they could, the outbreak spread north, hopping from one undervaccinated community to the next. When health officials in Utah County spoke with people who had tested positive, they often had no connection to other known cases. “Pretty quickly, we started to lose the links,” said Michael Leman, the county health department’s nursing director. Contact tracing, the cornerstone of containment, was failing.

Every week, the state health department posted a growing list of locations on its website — a Trader Joe’s, a Mormon temple, an aquarium, preschools — that people had visited while contagious. But many people who tested positive hadn’t been to those places, Leman said. “They could have gotten it at Walmart. They could have gotten it walking through a mall,” he said. “I mean, just anywhere in the public they could have been exposed.”

In February, high school students throughout Utah tested positive after a state wrestling tournament at Utah Valley University in Orem. A dashboard monitoring measles viruses in wastewater lit up with notifications around the state. “Wrestling really feels like our turning point,” said Nicholas Rupp, communications director at the Salt Lake County Health Department.

Salt Lake County’s shift from containment to mitigation meant prioritizing high-risk situations and relaxing control everywhere else. When a student has a confirmed case, for example, health officials meet with the school nurse to figure out which kids are most vulnerable. Unvaccinated children in the same classroom as someone infected are asked to stay home for 21 days, but those in other classrooms might not be, said Melanie Crossland, an epidemiologist at the Salt Lake health department. Some schools with high vaccination rates have opted to monitor student temperatures daily instead of requesting quarantines. One school created a separate space for the unvaccinated.

Crossland said such bespoke strategies entail a “huge” amount of effort but have staved off blowback that deflated her during covid.

“We give everything when we’re here,” she said, “but the days of killing ourselves, when legislatively no one is going to give us any help, are done.”

Daycare Dilemma

The outbreak has lasted so long that some children who have recovered from measles have since been hospitalized for what should be mild illnesses from common bugs, said Kerri Smith, a hospital pediatrician in southwest Utah. Measles can , impairing a body’s ability to fight other viruses. “It’s making children very susceptible to getting sick again,” Smith said.

Her eyes were bloodshot, and she looked drained from a week of long shifts. Since the outbreak began, she’s treated more than a dozen babies and children severely sick from measles.

“They’re usually admitted to the hospital with measles pneumonia, so they’re struggling to breathe, pulling for air below their ribs,” she said. “High fevers, 104 to 105, absolutely miserable, extremely fatigued, really dehydrated with sunken eyes.” Most children fully recover from measles, but a fraction develop permanent , a small percentage die, and in , measles kills a person years after the infection.

No one has died so far in Utah’s outbreak. And barring that tragic outcome, Smith and other doctors said, some parents fail to grasp the gravity of measles, even as their own children have tubes inserted into their small nostrils to deliver oxygen. Despite repeated warnings, doctors said, some unvaccinated family members of patients — who could be contagious — walk around the hospital while visiting their loved one. This means the waiting room, the elevator, the cafeteria, and other places need to be shut down for cleaning, and vulnerable people alerted.

“People don’t realize how easily this spreads,” Smith said.

Morris, the pediatrician working in two counties, recalled a conversation with a nonchalant father who didn’t seem to understand the need for quarantine. “I know this is an inconvenience to you,” she said. “It’s also a huge inconvenience to the parent who has an infant who could be severely impacted by this disease.”

On top of feeling depleted, doctors with young children said they are anxious. Emily Chin, a physician in Salt Lake County, worries she’ll bring measles home to her newborn. One evening, she sat in her garage after caring for a child with a rash. The patient’s measles test was still being processed, so Chin isolated herself in a room for the night, wearing an N95 mask instead of holding her infant.

Like many mothers in Utah, Chin plans to give her baby an early dose of the measles vaccine at 6 months old because of the outbreak, in addition to two doses at ages 1 and 4. Several mothers said they avoid travel and public places because they fear their babies could be infected. Some are delaying daycare. Others, like Kandace Hyland, a marketing director in Salt Lake County, don’t have that option.

Hyland was shocked when her daycare told her that it didn’t track the vaccine status of staff, even amid the outbreak. In March, she posted an calling for the state to require daycare staff to be vaccinated against the measles when the virus is spreading. Even if daycare staff file for vaccine exemptions, she said, parents could at least find out what portion of their babies’ caretakers pose a life-threatening risk.

Hyland sent her idea to the state health department. Nolen, the state epidemiologist, said she agreed with the concern, and was “talking with the division of licensing about the issue,” in an email shared with ºÚÁϳԹÏÍø News. Hyland also wrote the Division of Licensing and Background Checks. In an email, its director, Shannon Thoman-Black, replied that the division does “not have the legislative authority to implement a mandate.”

“They always talk about parents’ choice,” Hyland said. “But I don’t feel like I have a really good ‘parents’ choice’ right now.”

Measles’ Comeback

The U.S. will almost certainly this year or next, but it could be regained if political leadership backed nationwide campaigns to boost confidence in vaccines, said Demetre Daskalakis, a former director of the Centers for Disease Control and Prevention’s national immunization center and now the chief medical officer at the Callen-Lorde community health center in New York.

“Under Secretary Kennedy’s leadership, that’s unlikely to happen,” he said. “We’re going back to a pre-vaccine era.”

HHS spokesperson Emily Hilliard defended the secretary and his agency in an email, writing that the CDC has “surged resources” to contain measles outbreaks. “The CDC, HHS principles and the Secretary have been vocal that the MMR vaccine is the best way to protect yourself against measles,” she said.

Kennedy’s words and actions suggest otherwise. He’s said that the measles vaccine leads to “deaths every year,” which is . He continues a potential link between autism and vaccines, no matter how many there is none. And he oversaw abrupt changes to the recommended childhood vaccine schedule, a move called dangerous and not backed by science. A federal judge blocked those changes in March, but Trump recently issued an executive order to reexamine the schedule.

“It’s been confusing for the public,” said Dorothy Adams, executive director of the Salt Lake County Health Department.

In May, Kennedy met with Republican Utah Gov. Spencer Cox, who has said little about the state’s ongoing outbreak. Kennedy praised Utah’s action on Make America Healthy Again priorities, such as banning fluoride in public drinking water and easing restrictions on raw milk sales, according to Salt Lake City’s . Cox declined to comment for this article.

Meanwhile, the U.S. public health system has been further weakened by the Trump administration’s cuts and delays to public health grants.

“If you’re in the thick of it and you don’t know if you will be reimbursed, you adjust your response,” said Angela Dunn, a doctor and former Utah state epidemiologist. “This outbreak is a perfect storm of disinformation, trauma from the covid pandemic, and the drop in funding.”

Measles isn’t the only preventable malady making a comeback. As children played nearby in a sun-speckled park in Salt Lake City, Morris talked about a baby in the intensive care unit who was bleeding uncontrollably after a fall. The baby’s parents had refused an injection of vitamin K that helps blood clot in newborns. As they fretted over their infant, Morris said, she felt awful for them and regretted not being able to overcome mistrust in basic, lifesaving interventions. She had the same swirl of emotions when an unvaccinated toddler in her care recently died of whooping cough.

“I was one of the only people in the room with the nurse when the child coded,” she said with tears in her eyes. “You think, ‘I wish this child was vaccinated,’ but it’s hard because I also see how much grief these parents are holding.”

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

A 25-year-old midwife and a doctor in his early 30s are sick with Ebola symptoms, including fevers and severe joint pain, said their colleague Elisabeth Furaha, the medical director at in the northeastern province of Ituri.

They had cared for patients with similar symptoms in early May, before the outbreak was detected. One of the patients is now dead, Furaha said, and none of them has been tested for Ebola, even though samples were taken. The hospital still lacks access to tests, and an adequate supply of protective gowns and plastic masks to keep doctors and nurses safe.

“We live with fear in our stomachs,” Furaha said, speaking in French. “Every day, there are healthcare providers and patients dying.”

The outbreak took the world by surprise, with nearly 250 suspected Ebola cases and 80 deaths by the time Ebola was confirmed in Congo. Disturbed by the extent of silent transmission, and by cases in neighboring Uganda, the head of the World Health Organization sounded the group’s highest alarm on May 17, declaring the outbreak a “public health emergency of international concern.” That triggered donations from around the globe, of more than $162 million from the U.S. State Department to “stop the outbreak at its source and ensure Ebola does not reach the United States.”

But despite international attention, doctors in northeastern Congo say that many clinics lack even rudimentary supplies: gloves, protective gowns, masks, Ebola tests, and even clean water. Without rapid action to bolster those on the front line, researchers say, the outbreak will grow exponentially, costing even more money and risking lives far beyond Congo.

“All signs point to this becoming the biggest outbreak we’ve ever seen in the DRC,” said Nahid Bhadelia, the director of Boston University’s Center on Emerging Infectious Diseases. “That could lead to regional instability, and that has repercussions for the world.”

Some supplies from the country’s Ministry of Health, the WHO, and other United Nations agencies have landed in northeastern Congo, but not nearly enough to stock hundreds of health facilities where Ebola patients may seek care. Furaha has spent her own money on gloves, masks, and a tarp to build a makeshift tent to isolate patients with Ebola symptoms from the rest of the hospital. But she said it’s “inhumane” to put patients there before she can afford a mattress for them to rest on, or reliable access to tests.

Without testing, patients who turn out to have Ebola can infect those who don’t. Malaria and other diseases have initial symptoms similar to Ebola, causing fevers, soreness, and gastrointestinal problems.

Aid workers say shipments of medical supplies have been delayed by logistical hurdles, such as suspended flights within Congo and between Congo and neighboring countries.

“We need flights to move a lot of things, so this is a big challenge,” said Chikwe Ihekweazu, executive director of the WHO Health Emergencies Program. Small planes used in humanitarian crises have been permitted to move, but Ihekweazu said those are insufficient, expensive, and unsustainable.

Moving between remote clinics can be an impossible task because roads are often badly eroded or blocked by armed groups, said Rafaramalala Volanarisoa, a doctor with Catholic Relief Services in Kinshasa, Congo’s capital. Conflict, combined with the Trump administration’s abrupt withdrawal of funds from the U.S. Agency for International Development, has made Congo’s already ailing health system dysfunctional, Volanarisoa said.

“It’s very dangerous,” she said. “There is no medicine, no equipment, no surveillance.”

Dilapidated Labs

Researchers at Congo’s National Institute of Biomedical Research had built a sophisticated molecular biology laboratory for surveillance in Goma, the country’s eastern economic hub. But the lab stopped functioning last year after the Rwandan-backed violently of Goma and , stunting the flow of international aid.

Other cities in Congo lack well-stocked molecular biology labs, so they have instead relied on simple, automated tests that detect only one type of Ebola virus, said Eddy Kinganda-Lusamaki, a microbiologist at the biomedical institute. The shortcomings of these simple tests became obvious when the first samples tested in early May were negative for Ebola. Doctors were still worried, so they collected more samples, packed them in an icebox, and sent them to the institute’s main lab, in Kinshasa.

It took the samples six days to get there, traveling over bumpy roads and between storage facilities, Kinganda-Lusamaki said, and many were degraded by the time they reached the institute on May 14. Still, researchers identified an unusual variety of Ebola caused by the Bundibugyo virus, with a fatality rate of up to 50% and with no vaccines or drugs existing to treat it. They alerted authorities.

Later, investigators traced the first confirmed cases back to several deaths from unknown causes in a gold-mining town in Ituri. The Ebola was spreading there as early as March, with three of the group’s volunteers dying of unknown causes after burying bodies as part of their humanitarian work.

As of June 3, 363 Ebola cases and 62 deaths had been confirmed in the country, according to Congo’s . Tallies of suspected cases have fluctuated dramatically, a reflection of gaps in surveillance.

Researchers at the biomedical institute urgently want to improve labs in eastern Congo so they can test for Bundibugyo.

“We need support for local staff, training, equipment, consumables, and fuel,” for cars and backup generators, Kinganda-Lusamaki said. He also worries that expensive lab equipment could be stolen or destroyed by roving militias if war is permitted to continue in the east. “My brothers and sisters are perishing,” he said.

Conflict Aids Ebola’s Spread

Violence abets Ebola in other ways. As the outbreak was silently spreading in Ituri in late April, caught in the crossfire of armed groups fled, potentially carrying the virus with them. South of Ituri, Maurice Kakule Mutsunga, a doctor at a large general hospital, said he’s seen a surge of people by members of the Allied Democratic Forces, an linked to the Islamic State. “Every day this week we’ve received patients massacred by the ADF,” Kakule Mutsunga said in French, adding that bodies carried into the hospital have been decapitated by machetes.

People displaced by attacks are living in dense quarters that provide perfect conditions for a virus that spreads through touch. A person sick with Ebola, or recently killed by it, excretes sweat, blood, and other liquids packed with viruses that cause the disease.

Unpredictable attacks have also prevented health workers from tracking down people who may be infected in remote villages, to offer them care and keep the virus from spreading to others, Kakule Mutsunga said. Less than a quarter of contacts that Ebola responders identified had been monitored for signs of infection, the WHO reported on May 21.

Contact tracing and isolation — the cornerstones of an Ebola response — are also fraught because of the slow turnaround time on tests. Kakule Mutsunga said samples from his hospital in the town of Oicha are shipped to Kinshasa on humanitarian flights that take off only once they are at capacity. Many patients can’t or won’t isolate themselves for a week while they wait on results, he said, so they may pass the deadly virus to those closest to them.

Congolese researcher Gang Karume said that scientific information about Ebola isn’t reaching many communities, partly because of the trauma of daily life. On top of years of conflict, more than 220,000 young children are in provinces where Ebola is spreading. He wasn’t surprised to learn that angry youths have set fire to Ebola treatment centers and stolen corpses from morgues.

“An empty stomach does not have ears to listen,” he said.

To reach people, the is relying on its network of some 250 priests in Ituri. “They’re deeply rooted,” said Volanarisoa, with Catholic Relief Services, which partners with Caritas. “They understand how to approach communities who refuse to seek treatment.”

Through this network, Volanarisoa and her colleagues have gotten in touch with health workers seeking medical advice and protective equipment. With private donations, the Catholic charities have transferred money to priests in the northeast who arrange for jeeps to carry cash and supplies to clinics.

“What we’ve provided will only last for a few weeks,” Volanarisoa said. “The need is really immense.”

Another crippling factor is that the United States is far less involved than in the past, aid workers said. The Trump administration left the WHO, dissolved USAID, and downsized the Centers for Disease Control and Prevention.

“The U.S. is just not the player it used to be,” said Jeremy Konyndyk, a former USAID official who led the agency’s response to the world’s largest Ebola outbreak, in West Africa from 2013 to 2016. “We used to have a stockpile of gear for an Ebola response that we could throw on an airplane and get it to where it needs to go,” he said.

The U.S. used to give hundreds of millions of dollars to the WHO and nongovernmental organizations with experience fighting outbreaks. Under President Donald Trump, the State Department has announced that it will give $350 million to a pooled fund maintained by the U.N. Office for the Coordination of Humanitarian Affairs, which will then distribute funds to aid groups.

“This adds steps,” Konyndyk said. “The organizations that are ready to roll now are not confident that they will get money, so they’re kind of frozen.”

Even then, aid can take weeks to materialize on the front line. During the West Africa outbreak, more than two months passed between the WHO’s declaration of an international emergency and significant help arriving. In the interim, the Ebola death count more than quadrupled. Nurses, doctors, and ambulance drivers .

Front-line workers in Congo face a similar fate if help doesn’t arrive soon. Furaha said her hospital is running out of clean water. “All of this accumulates,” she said. “Healthcare workers will reach a breaking point.” 

Chloé Fostier Hernández helped translate interviews for this report.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

The CDC withheld the data for months as a team hit hard by mass layoffs and resignations sorted through the information. But now that scientists at the agency have posted their first batch of whole measles genomes — the genetic blueprint of the viruses — the rest should “start flowing more smoothly at a more rapid cadence,” said Kristian Andersen, an evolutionary virologist at the Scripps Research Institute who isn’t involved with the CDC’s effort but is following it.

The CDC did not answer queries from ºÚÁϳԹÏÍø News on its timeline for publishing measles data or analyses. However, once all the data is public, researchers can run that will signal whether outbreaks across the U.S. last year resulted from the continuous spread of the disease between states, rather than separate introductions from abroad. If there was continuous transmission for a year, that means the U.S. has lost its status as a country that has eliminated measles. That status, which the U.S. has held since 2000, reflects a country’s vaccination rates: Two doses of the measles-mumps-rubella vaccine prevent most infections and so stop outbreaks from growing.

More careful analyses take weeks.

“We should see a report in April,” Andersen said, “assuming no political interference.”

This is the first time that the U.S. has applied sophisticated genomic techniques to measles, which largely disappeared from the country a quarter-century ago because of broad vaccine uptake.

Declining , misinformation, and the Trump administration’s lagging response to outbreaks have fueled a resurgence of the disease. With at least 2,285 cases in 44 states, 2025 was the worst year for measles in more than three decades. This year is on track to surpass that, with 1,575 cases as of late March.

While welcoming the science, researchers say the government’s top priority should be to stop the virus from spreading.

“I think it’s incredibly important to do whole genome sequencing for outbreaks,” Andersen said, “but we shouldn’t need to do this for measles in the first place, because we have an extremely effective and safe vaccine.”

“That we’re even talking about this is nuts,” he added.

Health and Human Services Secretary Robert F. Kennedy Jr. and other government officials should sound an alarm about measles’ comeback and launch nationwide vaccine campaigns, said Rekha Lakshmanan, executive director of , a nonprofit in Houston that advocates for vaccine access.

“I applaud the science,” she said, “but the more urgent need is to get measles under control as quickly as possible.”

Top officials have instead downplayed the seriousness of the disease, and false notions about vaccines have been granted new life in Kennedy’s CDC. This includes abrupt changes to vaccine information on CDC websites that say aren’t based on evidence and endanger lives. 

Kennedy continues to promote unproven remedies that could mislead parents into believing that they can avoid vaccines without consequence. On the podcast in late February, Kennedy spoke at length about measures to improve America’s health but didn’t mention vaccines. He said preventive measures could entail “holistic medicine, or take vitamins, or take vitamin D, which is, as you know, it’s kind of miraculous.”

“The risk of measles remains low for most of the United States,” HHS spokesperson Emily Hilliard wrote. “CDC has made $8.5 million available to address measles response activities in 7 jurisdictions experiencing outbreaks,” she wrote. “The CDC, HHS principles, and the Secretary have been vocal that the MMR vaccine is the best way to protect yourself against measles.”

1,000 Genomes

In December, the CDC enlisted the help of one of the country’s leading centers for virus sequencing, the Broad Institute in Cambridge, Massachusetts. Major outbreaks in Texas, Utah, and South Carolina had been fueled by the same type of measles virus, labeled D8-9171. But since that type also circulates in Canada and Mexico, researchers need more data to discern whether it spread among states or entered the U.S. multiple times.

Whole genome sequencing provides that information because viruses evolve over time. The measles virus acquires a mutation every two to four transmissions between people, said Bronwyn MacInnis, director of pathogen surveillance at the Broad.

“There is enough signal in this data to tease apart questions at hand,” MacInnis said, “the main one being sustained transmission within this country.”

MacInnis’ team worked overtime to sequence the entire genomes of inactivated measles viruses that had been collected from states in 2025 and 2026.

“We’ve done about 1,000 samples and delivered the genome data back to the CDC,” sending it on a rolling basis since December, MacInnis said. “This is the CDC’s data to publish.”

The CDC didn’t post a single one of those genomes until late March, when eight appeared on a public database hosted by the National Center for Biotechnology Information. By April 1, an additional 154 had gone online.

“It should be on NCBI within a couple of weeks of being produced,” Andersen said, “and certainly not take longer than a month when you have an active outbreak.”

Genomic data holds clues about how outbreaks start and spread. It allows researchers to develop tests, treatments, and vaccines — and detect variants that might evade them.

Such data was critical in the covid pandemic. Chinese and Australian scientists online on Jan. 10, 2020, of sequencing it. “It definitely shouldn’t take the CDC months,” said Eddie Holmes, the Australian virologist who helped publish the first coronavirus sequence.

One reason for the delay is that the CDC’s measles lab has been sorely understaffed amid mass layoffs and other turmoil at the agency over the past year, a CDC scientist told ºÚÁϳԹÏÍø News. Another reason, the researcher added, is a learning curve: The CDC and health departments haven’t needed to sequence hundreds of whole measles genomes before now. (ºÚÁϳԹÏÍø News agreed not to identify the scientist, who feared retaliation.)

In contrast with the CDC, the Utah Public Health Lab has shared measles genomes rapidly. Most of some 970 measles genomes posted online since Jan. 1, 2025, were sequenced by the state, hailing from Utah, Arizona, South Carolina, and other states willing to share them.

“We’ve only got a handful of samples from Texas that were collected kind of in the middle of their outbreak,” said Kelly Oakeson, a genomics researcher at the Utah Department of Health and Human Services. The genomes of the Texas and Utah measles viruses are similar but distinct, Oakeson said, meaning that intermediate versions of the virus are missing.

If the genetic code of viruses collected late in the Texas outbreak are a closer match to those from Utah’s, that will suggest that spread was continuous and the country has lost its measles-free status. The hundreds of genome sequences still sitting at the CDC probably hold the answer.

Waiting on the CDC

The CDC expected to finish its analysis before April, said Daniel Salas, executive manager of the immunization program at the Pan American Health Organization, which works with the World Health Organization. That’s when PAHO was slated to evaluate the United States’ measles status.

He said PAHO delayed its evaluation until the organization’s annual meeting in November, partly because the CDC needed more time to do the genomic analysis and partly because the measles status of Mexico, Bolivia, and other countries is also under review, and holding staggered meetings for each country is inefficient.

The U.S. is the only country using whole genome sequencing to answer the elimination question, Salas said. Typically, countries classify measles viruses according to a tiny snippet of genes, then assume that large outbreaks caused by the same type are linked. Whole genomes provide a more accurate view.

“If the U.S. can fill in the blanks with genomic data, that’s a sort of breakthrough,” Salas said. “That doesn’t mean other countries are going to be able to pull off this kind of analysis,” he added. “It takes a lot of specialized knowledge and resources.”

Equipment to sequence and analyze genomes costs upward of $100,000, and the cost to process each sample, including paying the researchers involved, typically ranges from $100 to $500 per sequence.

“I’m pro-science, but we shouldn’t have to do this,” said Theresa McCarthy Flynn, president of the North Carolina Pediatrics Society. “We don’t have to have a measles epidemic.”

Flynn said she regularly fields questions from parents concerned by misinformation spread by Kennedy and anti-vaccine groups, including the one he founded before joining the Trump administration. Parents have also pointed to changes in the CDC’s recommendations and to its websites that are at odds with the scientific consensus.

Before Kennedy took the helm, a said “Vaccines do not cause autism” in prominent type, and listed in premier scientific journals that refuted a link between vaccines and developmental disorders.

Last year, shifted to saying, “Studies supporting a link have been ignored by health authorities.” The high-quality studies were replaced with a report from a single investigator who has ties to anti-vaccine groups. In an email to ºÚÁϳԹÏÍø News, HHS spokesperson Hilliard echoed the altered website’s claims about vaccines, disregarding extensive studies on the topic.

Flynn, of the pediatrics association, said, “The CDC itself is spreading misinformation about vaccines. I cannot overstate the seriousness of this.”

Although the acting director of the CDC, Jay Bhattacharya, says vaccines are the best way to prevent measles, he too has undermined vaccine policy. He said the controversial to reduce the number of vaccines recommended to children was based on “gold standard science.” In fact, the new schedule makes the among peer nations. Hilliard wrote that the updated schedule was “aligning U.S. guidance with international norms.”

A federal court temporarily invalidated the change last month in a lawsuit brought by the American Academy of Pediatrics and other groups.

Bhattacharya hasn’t held briefings with the public or the press on the surge of measles this year or activated the CDC’s emergency capabilities.

“Normally, we’d have a big push to get vaccination rates up in areas where it’s low. We’d do a big social media push, put out ads on getting vaccinated,” said another CDC scientist whom ºÚÁϳԹÏÍø News agreed not to identify, because of fears of retaliation. “People at the CDC want to do this, but political leadership at the agency has not allowed the CDC to do it.”

Further, the Trump administration’s cuts and delays to public health funds have made it hard for local health officials to protect communities. Philip Huang, director at Dallas County Health and Human Services in Texas, said the department lost over $4 million when the administration clawed back about $11 billion from health departments early last year as a measles outbreak surged in the state.

“We lost 27 staff and had to cancel over 20 of our community vaccination efforts, including to schools identified as having low vaccination rates,” he said. “There are simultaneous attacks on immunizations that are making our jobs harder.”

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

This posting combined Donald Trump’s longtime passion to use the offshore base to move “some bad dudes” out of the United States with a promise made shortly after his inauguration last year to hold thousands of noncitizens there. The naval base is known for the and of men suspected of terrorism in the wake of 9/11.

“Deployments are typically not something you can say no to,” Stewart said. She pleaded with the coordinating office, which found another nurse to go in her place.

Other public health officers who worked at Guantánamo in the past year described conditions there for the detainees, some of whom learned they were in Cuba from the nurses and doctors sent to care for them. They treated immigrants detained in a dark prison called Camp 6, where no sunlight filters in, said the officers, whom ºÚÁϳԹÏÍø News agreed not to name because they fear retaliation for speaking publicly. It previously held people with suspected ties to al-Qaida. The officers said they were not briefed ahead of time on the details of their potential duties at the base.

Although the Public Health Service is not a branch of the U.S. armed forces, its uniformed officers — roughly 5,000 doctors, nurses, and other health workers — act like stethoscope-wearing soldiers in emergencies. The government deploys them during hurricanes, wildfires, mass shootings, and measles outbreaks. In the interim, they fill gaps at an alphabet soup of government agencies.

The Trump administration’s to curb immigration have created a new type of health emergency as the number of people detained reaches . About 71,000 immigrants are currently imprisoned, according to , which shows that most have no criminal record.

Homeland Security Secretary Kristi Noem has said: “President Donald Trump has been very clear: Guantanamo Bay will hold the worst of the worst.” However, that many of the men shipped to the base had no criminal convictions. As many as 90% of them were described as “low-risk” in a from ICE.

In fits and starts, the Trump administration has sent about 780 noncitizens to Guantánamo Bay, The New York Times. Numbers fluctuate as new detainees arrive and others are returned to the U.S. or deported.

While some Public Health Service officers have provided medical care to detained immigrants in the past, this is the first time in American history that Guantánamo has been used to house immigrants who had been living in the U.S. Officers said ICE postings are getting more common. After dodging Guantánamo, Stewart was instructed to report to an ICE detention center in Texas.

“Public health officers are being asked to facilitate a man-made humanitarian crisis,” she said.

Seeing no option to refuse deployments that she found objectionable, Stewart resigned after a decade of service. She would give up the prospect of a pension offered after 20 years.

“It was one of the hardest decisions I ever had to make,” she said. “It was my dream job.”

One of her PHS colleagues, nurse Dena Bushman, grappled with a similar moral dilemma when she got a notice to report to Guantánamo a few weeks after the shooting at the Centers for Disease Control and Prevention in August. Bushman, who was posted with the CDC, got a medical waiver delaying her deployment on account of stress and grief. She considered resigning, then did.

“This may sound extreme,” Bushman said. “But when I was making this decision, I couldn’t help but think about how the people who fed those imprisoned in concentration camps were still part of the Nazi regime.”

Others have resigned, but many officers remain. While they are alarmed by Trump’s tactics, detained people need care, multiple PHS officers told ºÚÁϳԹÏÍø News.

“We do the best we can to provide care to people in this shit show,” said a PHS nurse who worked in detention facilities last year.

“I respect people and treat them like humans,” she said. “I try to be a light in the darkness, the one person that makes someone smile in this horrible mess.”

The PHS officers conceded that their power to protect people was limited in a detention system fraught with overcrowding, disorganization, and the psychological trauma of uncertainty, family separations, and sleep deprivation.

“Ensuring the safety, security, and well-being of individuals in our custody is a top priority at ICE,” said Tricia McLaughlin, chief spokesperson for the Department of Homeland Security, in an emailed statement to ºÚÁϳԹÏÍø News.

Adm. Brian Christine, assistant secretary for health at the Department of Health and Human Services, which oversees the Public Health Service, said in an email: “Our duty is clear: say “Yes Sir!”, salute smartly, and execute the mission: show up, provide humane care, and protect health.” Christine is a who, until recently, was a urologist specializing in testosterone and male fertility issues.

“In pursuit of subjective morality or public displays of virtue,” he added, “we risk abandoning the very individuals we pledged to serve.”

Into the Unknown

In the months before Stewart resigned, she reflected on her previous deployments, during Trump’s first term, to immigration processing centers run by Customs and Border Protection. Fifty women were held in a single concrete cell in Texas, she recalled.

“The most impactful thing I could do was to convince the guards to allow the women, who had been in there for a week, to shower,” she said. “I witnessed suffering without having much ability to address it.”

Stewart spoke with Bushman and other PHS officers who were embedded at the CDC last year. They assisted with the agency’s response to ongoing measles outbreaks, with sexually transmitted infection research, and more. Their roles became crucial last year as the Trump administration laid off droves of CDC staffers.

Stewart, Bushman, and a few other PHS officers at the CDC said they met with middle managers to ask for details about the deployments: If they went to Guantánamo and ICE facilities, how much power would they have to provide what they considered medically necessary care? If they saw anything unethical, how could they report it? Would it be investigated? Would they be protected from reprisal?

Stewart and Bushman said they were given a PHS office phone number they could call if they had a complaint while on assignment. Otherwise, they said, their questions went unanswered. They resigned and so never went to Guantánamo.

PHS officers who were deployed to the base told ºÚÁϳԹÏÍø News they weren’t given details about their potential duties — or the standard operating procedure for medical care — before they arrived.

Stephen Xenakis, a retired Army general and a psychiatrist who has advised on medical care at Guantánamo for two decades, said that was troubling. Before health workers deploy, he said, they should understand what they’ll be expected to do.

The consequences of insufficient preparation can be severe. In 2014, the Navy one of its nurses at Guantánamo who refused to force-feed prisoners on hunger strike, who were protesting inhumane treatment and indefinite detention. The protocol : A person was shackled to a five-point restraint chair as nurses shoved a tube for liquid food into their stomach through their nostrils.

“He wasn’t given clear guidance in advance on how these procedures would be conducted at Guantánamo,” Xenakis said of the nurse. “Until he saw it, he didn’t understand how painful it was for detainees.”

The American Nurses Association and Physicians for Human Rights sided with the nurse, saying his objection was . After a year, the military dropped the charges.

A uniformed doctor or nurse’s power tends to depend on their rank, their supervisor, and chains of command, Xenakis said. He helped put an end to some inhumane practices at Guantánamo more than a decade ago, when he and other retired generals and admirals to certain interrogation techniques, such in which interrogators slammed the heads of detainees suspected of terrorism against a wall, causing slight concussions. Xenakis argued that science didn’t support “walling” as an effective means of interrogation, and that it was unethical, amounting to .

Torture hasn’t been reported from Guantánamo’s immigration operation, but obtained through a Freedom of Information Act request by the government watchdog group American Oversight note concerns about detainees resorting to hunger strikes and self-harm.

“Welfare checks with potential hunger strike IA’s,” short for illegal aliens, says an April 30 note from a contractor working with ICE. “In case of a hunger strike or other emergencies,” the report adds, the PHS and ICE are “coordinating policies and procedures.”

“De-escalation of potential pod wide hunger strike/potential riot,” says an entry from July 8. “Speak with alien on suicide watch regarding well being.”

and have reported delayed medical care at immigration detention facilities and dangerous conditions, including overcrowding and a lack of sanitation. Thirty-two people died in ICE custody in 2025, making it the deadliest year in two decades.

“They are arresting and detaining more people than their facilities can support,” one PHS officer told ºÚÁϳԹÏÍø News. The most prevalent problem the officer saw among imprisoned immigrants was psychological. They worried about never seeing their families again or being sent back to a country where they feared they’d be killed. “People are scared out of their minds,” the officer said.

No Sunlight

The PHS officers who were at Guantánamo told ºÚÁϳԹÏÍø News that the men they saw were detained in either low-security barracks, with a handful of people per room, or in Camp 6, a dark, high-security facility without natural light. The ICE shift reports describe the two stations by their position on the island, Leeward for the barracks and Windward for Camp 6. About 50 sent to Guantánamo in December and January have languished at Camp 6.

A Navy hospital on the base mainly serves the military and other residents who aren’t locked up — and in any case, its capabilities are limited, the officers said. To reduce the chance of expensive medical evacuations back to the U.S. to see specialists quickly, they said, the immigrants were screened before being shipped to Guantánamo. People over age 60 or who needed daily drugs to manage diabetes and high blood pressure, for example, were generally excluded. Still, the officers said, some detainees have had to be evacuated back to Florida.

PHS nurses and doctors said they screened immigrants again when they arrived and provided ongoing care, fielding complaints including about gastrointestinal distress and depression. One ICE monthly progress report says, “The USPHS psychologist started an exercise group” for detainees.

Doctors’ requests for lab work were often turned down because of logistical hurdles, partly due to the number of agencies working together on the base, the officers said. Even a routine test, a complete blood count, took weeks to process, versus hours in the U.S.

DHS and the Department of Defense, which have coordinated on the Guantánamo immigration operation, did not respond to requests for comment about their work there.

One PHS officer who helped medically screen new detainees said they were often surprised to learn they were at Guantánamo.

“I’d tell them, ‘I’m sorry you are here,’” the officer said. “No one freaked out. It was like the ten-millionth time they had been transferred.” Some of the men had been detained in various facilities for five or six months and said they wanted to return to their home countries, according to the officer. Health workers had neither an answer nor a fix.

Unlike ICE detention facilities in the U.S., Guantánamo hasn’t been overcrowded. “I have never been so not busy at work,” one officer said. A military base on a tropical island, Guantánamo such as snorkeling, paddleboard yoga, and kickboxing to those who aren’t imprisoned. Even so, the officer said they would rather be home than on this assignment on the taxpayer’s dime.

Transporting staff and supplies to the island and maintaining them on-base is enormously expensive. The government paid an estimated $16,500 per day, per detainee at Guantánamo, to hold those accused of terrorism, according to a 2025 of DOD data. (The average cost to detain immigrants in ICE facilities in the U.S. is $157 a day.)

Even so, the : Congress granted ICE a record $78 billion for fiscal year 2026, a staggering increase from $9.9 billion in 2024 and $6.5 billion nearly a decade ago.

Last year, the Trump administration also from the national defense budget to immigration operations, according to a report from congressional Democrats. About $60 million of it went to Guantánamo.

“Detaining noncitizens at Guantanamo is far more costly and logistically burdensome than holding them in ICE detention facilities within the United States,” wrote Deborah Fleischaker, a former assistant director at ICE, in submitted as part of a lawsuit brought by the American Civil Liberties Union early last year. In December, a federal judge rejected the Trump administration’s request to dismiss a separate ACLU case questioning the legality of detaining immigrants outside the U.S.

Anne Schuchat, who served with the PHS for 30 years before retiring in 2018, said PHS deployments to detention centers may cost the nation in terms of security, too. “A key concern has always been to have enough of these officers available for public health emergencies,” she said.

Andrew Nixon, an HHS spokesperson, said the immigration deployments don’t affect the public health service’s potential response to other emergencies.

In the past, PHS officers have stood up medical shelters during hurricanes in Louisiana and Texas, rolled out covid testing in the earliest months of the pandemic, and provided crisis support after the deadly shooting at Sandy Hook Elementary School and the Boston Marathon bombing.

“It’s important for the public to be aware of how many government resources are being used so that the current administration can carry out this one agenda,” said Stewart, one of the nurses who resigned. “This one thing that’s probably turning us into the types of countries we have fought wars against.”

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

“It’s just the cost of doing business with our borders being somewhat porous for global and international travel,” Abraham said. “We have these communities that choose to be unvaccinated. That’s their personal freedom.”

Infections from other countries, however, accounted for only of measles cases detected since Jan. 20, 2025, the official start of the deadly measles outbreak in West Texas, which spread to other states and Mexico. The rest were acquired domestically. This marks a change since the U.S. eliminated measles in 2000. Measles occasionally popped up in the U.S. from people infected abroad, but the cases rarely sparked outbreaks, because of extremely high rates of vaccination. Two doses of the measles, mumps, and rubella vaccine strongly prevent infection and halt the virus’s spread.

To maintain its measles elimination status, the U.S. must prove that the virus has not circulated continuously in the nation for a year, between Jan. 20, 2025, and Jan. 20, 2026. To answer the question, scientists are examining whether the major outbreaks in South Carolina, Utah, Arizona, and Texas were linked.

Health officials confirmed that the main measles virus strain in each of these outbreaks is D8-9171. But because this strain also occurs in Canada and Mexico, CDC scientists are now analyzing the entire genomes of measles viruses — about 16,000 genetic letters long — to see whether those in the United States are more closely related to one another than to those in other countries.

The CDC expects to complete its studies within a couple of months and make the data public. Then the Pan American Health Organization, which oversees the Americas in partnership with the World Health Organization, will decide whether the U.S. will lose its measles elimination status. And that would mean that potentially deadly, and preventable measles outbreaks could become common again.

“When you hear somebody like Abraham say ‘the cost of doing business,’ how can you be more callous,” said pediatrician and vaccine specialist Paul Offit, in an hosted by the health blog on Jan. 20. “Three people died of measles last year in this country,” Offit added. “We eliminated this virus in the year 2000 — eliminated it. Eliminated circulation of the most contagious human infection. That was something to be proud of.”

Abraham said vaccination remains the most effective way to prevent measles but that parents must have the freedom to decide whether to vaccinate their children. Several states have loosened school vaccine requirements since 2020, and vaccine rates . A record rate of kindergartners, representing about obtained vaccine exemptions for the 2024-25 school year.

Information on vaccines has been muddied by Health and Human Services Secretary Robert F. Kennedy Jr., who previously founded an anti-vaccine organization. He has undermined vaccines throughout his tenure. On national television, he has repeated scientifically debunked rumors that vaccines may cause autism, .

Jennifer Nuzzo, director of the Pandemic Center at Brown University, disparaged the Trump administration’s focus on finding genetic technicalities that may spare the country’s measles-free status. “This is the wrong thing to pay attention to. Our attention has to be on stopping the outbreaks,” she said.

“If we keep our status, it should be because we have stopped the spread of measles,” she said. “It’s like they’re trying to be graded on a curve.”

The Trump administration impeded the CDC’s ability to assist West Texas during the first critical weeks of its outbreak and slowed the release of federal emergency funds, according to ºÚÁϳԹÏÍø News investigations. However, the agency stepped up its activity last year, providing local health departments with measles vaccines, communication materials, and testing. Abraham said HHS would give South Carolina $1.5 million to respond to its outbreak, which began nearly four months ago and had reached 646 cases as of Jan. 20.

If the CDC’s genomic analyses show that last year’s outbreaks resulted from separate introductions from abroad, political appointees will probably credit Kennedy for saving the country’s status, said Demetre Daskalakis, a former director of the CDC’s national immunization center, who resigned in protest of Kennedy’s actions in August.

And if studies suggest the outbreaks are linked, Daskalakis predicted, the administration will cast doubt on the findings and downplay the reversal of the country’s status: “They’ll say, who cares.”

Indeed, at the briefing, Abraham told a that a reversal in the nation’s status would not be significant: “Losing elimination status does not mean that the measles would be widespread.”

Data shows otherwise. Case counts last year were the highest since 1991, before the government enacted vaccine policies to ensure that all children could be protected with measles immunization.

Lauren Sausser contributed reporting.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

In August, Bauer and her colleagues of 46 previous studies on Tylenol, autism, and attention-deficit/hyperactivity disorder. Many found no link between the drug and the conditions, while some suggested Tylenol might occasionally exacerbate other potential causes of autism, such as genetics.

Bauer, an epidemiologist at the University of Massachusetts-Lowell, and her team called for more judicious use of the drug until the science is settled.

On Monday, President Donald Trump stood beside Health and Human Services Secretary Robert F. Kennedy Jr. for what he called a “historic” announcement on autism. “If you’re pregnant, don’t take Tylenol, and don’t give it to the baby after the baby is born,” Trump said. “There are certain groups of people that don’t take vaccines and don’t take any pills that have no autism,” he added, without providing evidence. “They pump so much stuff into those beautiful little babies, it’s a disgrace.”

A released alongside the White House briefing cited Bauer’s analysis. But she was alarmed by Trump’s comments. If prenatal Tylenol has any association, which it may not, it would help account for only a fraction of cases, she said. Further, research has not deeply examined Tylenol risks in young children, refute a link between vaccines and autism.

Bauer worries such statements will cut both ways: People may put themselves at risk to avoid vaccines and Tylenol, the only safe painkiller for use during pregnancy. And she frets that scientists might outright reject her team’s measured concerns about Tylenol in a backlash against misleading remarks from Trump and other members of his “Make America Healthy Again” movement.

“I’m really concerned about how this message is going to play out,” she said. “It’s a sound-bite universe, and everyone wants a simple solution.”

Autism experts at the Centers for Disease Control and Prevention were neither consulted for the White House’s long-awaited autism announcement nor asked to review a draft of the findings and recommendations, CDC scientists told ºÚÁϳԹÏÍø News, which agreed not to identify them because they fear retaliation.

“Typically, we’d be asked to provide information and review the report for accuracy, but we’ve had absolutely no contact with anyone,” one CDC researcher said. “It is very unusual.”

Trump and Kennedy promised this year that under their leadership the federal government would swiftly figure out what causes autism. Scientists who work in the field have been skeptical, noting that decades of research has shown that no single drug, chemical, or other environmental factor is strongly linked to the developmental disorder. In addition, both Trump and Kennedy the notion that childhood vaccines may cause autism.

Helen Tager-Flusberg, director of the Center for Autism Research Excellence at Boston University, called Trump’s comments dangerous. Fevers can harm the mother and the developing fetus, she said, adding that fevers are more strongly associated with autism than Tylenol.

In an emailed response to queries, HHS spokesperson Andrew Nixon said, “We are using gold-standard science to get to the bottom of America’s unprecedented rise in autism rates.”

White House spokesperson Kush Desai wrote, “President Trump pledged to address America’s rising rate of autism, and to do so with Gold Standard Science.”

Had CDC scientists been allowed to brief Kennedy, they say they would have cautioned that simple fixes won’t make a dent in the number of autism cases in the United States: As many as 1 in 31 8-year-old children in 2022.

Systemic changes, such as regulations on air pollution, which has been linked to asthma and developmental disabilities including autism, and assistance for parents of disabled children, could improve lives for far more Americans with autism and other conditions than by the Trump administration on Sept. 22, researchers say.

One federal action is to consider updating the label on Tylenol and to “encourage clinicians to exercise their best judgment in use of acetaminophen for fevers and pain in pregnancy by prescribing the lowest effective dose for the shortest duration.” The American College of Obstetricians and Gynecologists already recommends acetaminophen “as needed, in moderation, and after consultation with a doctor.”

‘Political Crusade’

Despite Kennedy’s many years of speaking about autism, he rarely cites credible or expert recommendations, Tager-Flusberg said. Instead, Kennedy , scientifically debunked theories linking vaccines to autism, despite published in peer-reviewed journals that .

At the Sept. 22 briefing, Trump said he spoke with Kennedy about autism 20 years ago: “We understood a lot more than a lot of people who studied it,” he said. Ahead of Trump’s first term in 2017, he met with the president to consider a commission on vaccine safety and autism. It didn’t happen then. But soon after Kennedy was confirmed as health secretary, he “preventable,” “environmental toxins,” and contradicted the results of a finding that the main driver of rising autism diagnoses was that doctors increasingly recognize the disorder.

At a televised Cabinet , Kennedy told Trump, “By September, we will know what has caused the autism epidemic and we’ll be able to eliminate those exposures.”

“You stop taking something, you stop eating something, or maybe it’s a shot,” Trump replied.

“He is on a political crusade,” Tager-Flusberg said of Kennedy, adding that vaccines, Tylenol, aluminum, and food dyes make for simple targets to rally against. “We know genetics is the most significant risk factor,” she said, “but you can’t blame Big Pharma for genetics, and you can’t build a political movement on genetics research and ride to victory.”

“RFK makes our work harder,” said Peter Hotez, a vaccine researcher and the author of a book about his autistic daughter, “Vaccines Did Not Cause Rachel’s Autism.” He said the book stemmed from conversations with Kennedy in 2017, in which Hotez shared studies pinpointing more than a hundred genes linked to autism, and research into the complex interplay between genetics, biological processes, and things that children and fetuses encounter during development.

“I sat down with him and explained what the science says, but he was unwilling or incapable of thinking deeply about it,” Hotez said. “He is extremely careless.”

In addition to its focus on Tylenol, the White House said it would “prescribing information” on leucovorin — a medication related to the B vitamin folate — to reflect its use as an autism treatment. A small in 2012-13 suggested the drug may help treat language problems in some children with autism. Tager-Flusberg said the findings warrant further study but clarified these were “old data, not a breakthrough.”

Likewise, studies finding a modest association between autism and prolonged Tylenol use were published years ago. Researchers have suggested the medicine might occasionally exacerbate factors associated with autism, and , a biological condition that occurs for a variety of reasons that scientists are still unraveling.

Still, these studies couldn’t rule out the possibility that fevers prompting women to take Tylenol, rather than the medicine itself, might instead be to blame. — including by vaccines — have also been linked to autism.

Nonetheless, Bauer’s recommendation would be to pause before taking acetaminophen while pregnant — blanket advice that doctors give for all medications during that period, but which may be ignored. “Try to alleviate discomfort in some other ways, like with a cold compress, hydration, or massage, before taking it,” Bauer said.

She welcomed the White House’s motion to consider labeling Tylenol to emphasize judicious use of the drug but worries about how the MAHA movement might distort a careful message. On Sept. 2, the right-wing news outlet One America News Network with newly appointed CDC vaccine adviser Robert Malone, writing that Malone “speculates RFK Jr. may have an important announcement this month regarding a potential link between Tylenol, multiple vaccinations and autism in children.”

“I was sick to my stomach,” Bauer said, concerned that Kennedy would link her study to discredited theories, causing doctors and scientists to reject her far more measured work.

‘The Boy Who Cried Wolf’

Several and have called for Kennedy’s removal or resignation. Many scientists are skeptical of what he says because much of it has been misleading or wrong. For example, HIV isn’t the only cause of AIDS (), that antidepressant drugs cause mass shootings (), that older adults don’t have severe autism (), that the measles vaccine causes brain swelling (), that covid vaccines were the deadliest vaccines ever made (), that vaccines aren’t safety-tested (), and that vaccines contribute to autism ().

“This is like the boy who cried wolf,” said Brian Lee, an epidemiologist at Drexel University. “One day he might be right about something and Americans who are not prone to conspiracies won’t trust it because it’s coming from RFK’s mouth. And that could be a problem.”

What’s more, the Trump administration is eroding scientists’ ability to probe the safety of pharmaceuticals, said Robert Steinbrook, head of health research at Public Citizen, a nonprofit consumer protection group.

“Public Citizen is very supportive of research on medications that could be linked to diseases,” he said. “But it needs to be through an open process, which looks at scientific evidence, and which doesn’t cherry-pick studies to support a preconceived point of view.”

Steinbrook said the administration has undermined his confidence in the government’s ability to conduct credible work. The Food and Drug Administration has held less than a third the number of advisory committee meetings this year as it did last, meaning fewer opportunities for experts to discuss research on the risks and benefits of drugs. The Trump administration has fired hundreds of career scientists at the CDC and FDA and cut millions of dollars in research funds, including to projects studying autism.

In early September, the CDC issued an unusual contract with the Rensselaer Polytechnic Institute to analyze datasets for signs that vaccinated children were more likely to have autism. Unlike with other research initiatives, the CDC didn’t post an open call for applications in advance. This allows agency experts to review proposals and select studies best designed to answer the question at hand.

CDC researchers told ºÚÁϳԹÏÍø News that experts in the agency’s autism and disability group weren’t aware of the contract or asked to review the proposal. That’s important, they said, because researchers digging through data to find clues about autism must show how they’ll rule out biological and environmental exposures that muddy the results, and ensure that children have been accurately diagnosed. One researcher said, “It absolutely looks like Kennedy has subverted the grantmaking process.”

The CDC and HHS did not respond to ºÚÁϳԹÏÍø News’ requests for information on the grant, including through a Freedom of Information Act request.

The new vaccine study is separate from Kennedy’s autism data-science initiative, which was posted as an open call at the National Institutes of Health. “The hope is that something good comes of it, and that the government won’t cherry-pick or censor what scientists find out,” Lee said.

Bauer said she didn’t apply to be part of the initiative because of Kennedy’s outsize presence at HHS.

“I would not take his funding because it could take away from the credibility of my study,” she said, “in the same way that taking money from pharmaceutical companies does.”

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The leadership upheavals, which he says will restore trust in federal health agencies, have shaken the confidence many states have in the CDC and led to the fracturing of a national, cohesive immunization policy that’s endured for .

States and medical societies that long worked in concert with the CDC are breaking with federal recommendations, saying they no longer have faith in them amid the turmoil and Kennedy’s criticism of vaccines. Roughly seven months after Kennedy’s nomination was confirmed, they’re rushing to draft or release their own vaccine recommendations, while new groups are forming to issue immunization guidance and advice.

How the new system will work is still being hammered out. Vaccine recommendations from states, medical societies, and other groups are likely to diverge, creating dueling guidance and requirements. Schoolchildren in New York may still generally need immunizations, for example, while others in places such as Florida may not need many vaccines.

There are potential financial ramifications too, because historically, private insurers, Medicaid, and Medicare have generally covered only vaccines recommended by the federal government. If the CDC and its advisory group, which began Sept. 18 in Atlanta, stop recommending certain vaccines, hundreds of millions of people could wind up paying for shots that previously cost them nothing. Some states are already taking steps to prevent that from happening, which means where people live could determine if they will face costs.

“You’re seeing a proliferation of recommendations, and the recommendations by everybody are different from the CDC,” said , a University of Minnesota epidemiologist who launched an ad hoc group that provides vaccine guidance. “States and medical societies are basing their recommendations on science. The recommendations out of CDC are magic, smoke, and mirrors.”

Kennedy has defended changes at the CDC and the revamping of the vaccine committee as necessary, saying previous advisory panel members had and agency leadership botched its pandemic response.

The CDC is “the most corrupt agency at HHS, and maybe the government,” Kennedy said at a . Susan Monarez, the ousted CDC director, testified Sept. 17 at another Senate hearing about how Kennedy told her to preapprove vaccine recommendations from the advisory panel or be fired.

Kennedy has said HHS also plans to investigate vaccine injuries he says are . The CDC investigates injuries that are reported by providers or patients, but Kennedy has said he wants to recast the entire program. The Food and Drug Administration is already who died following covid-19 vaccination.

HHS didn’t return an email seeking comment.

The actions by states, medical societies, and other groups reflect a mounting lack of confidence in federal leadership, public health leaders say, and the break from the CDC is happening at a rapid clip.

The Democratic governors of California, Hawaii, Oregon, and Washington — fashioning themselves as the West Coast Health Alliance — are coordinating to develop vaccine recommendations that won’t necessarily follow those from the CDC. The governors said in a that the CDC shake-up has “impaired the agency’s capacity to prepare the nation for respiratory virus season and other public health challenges” and this week for vaccination against viruses such as covid, influenza, and respiratory syncytial virus.

A group of northeastern states are exploring a similar collaborative.

“The worst thing that could happen is that we have 50 different recommendations for the covid vaccine. That will destroy public health,” said Massachusetts Public Health Commissioner Robbie Goldstein, who has been involved with the effort. He’s also spoken with leaders of the West Coast alliance. “I’m really hopeful that we do come together in larger and larger collaboratives with the same recommendations or very similar recommendations,” he said while speaking to a group of reporters this month.

And medical societies such as the American Academy of Pediatrics are releasing covid vaccine recommendations for the first time from the CDC’s guidance.

Some states are seizing on the split to ensure access to shots. Massachusetts is to cover vaccines recommended by the state health department rather than paying only for those suggested by the CDC, making it the first state to guarantee such continued coverage. AHIP, a trade group representing insurers, that health plans will cover immunizations, including updated formulations of covid and flu vaccines, that were recommended by the CDC panel as of Sept. 1 with no cost sharing through the end of 2026.

Pennsylvania is to give covid vaccines even if they’re not recommended by the federal agency. Instead, they can follow recommendations from the pediatric academy and other medical groups.

Florida, meanwhile, plans to for schoolchildren to get immunizations against chickenpox, meningitis, hepatitis B, and some other diseases. State lawmakers would need to take action to end mandates for all vaccines.

Joseph Ladapo, the state’s surgeon general, said in a that any vaccine requirement is wrong and “drips with disdain and slavery.”

Some doctors criticize the decision as a dangerous step backward.

“This is a terrifying decision that puts our children’s lives at risk,” said , former acting director of the CDC, in an emailed statement.

The first school vaccine mandate was rolled out in the , for smallpox. While all states have vaccine requirements for schoolchildren, immunization rates for kindergarten students declined while cases of vaccine-preventable in 2024 and 2025.

Rochelle Walensky, the Biden administration’s first CDC director, warned of the “polarization” of state-by-state approaches. “It’s like your head is in the oven and your feet are in the freezer and, on average, we’re at 95% vaccination. That doesn’t work in measles — every place has to be at 95% vaccination.” She was referring to the proportion of a population that needs to be vaccinated to provide herd immunity.

Kennedy’s actions have thrust vaccines center stage and made him fodder for comedy. The Marsh Family, a British musical group, on Sept. 7 of Paul Simon’s “Me and Julio Down by the Schoolyard,” with the chorus, “We’ll see measles and polio down in the schoolyard.”

HBO comedian said the CDC could be known by the title “Disease” during a recent episode of his show. And Stephen Colbert used his monologue on “The Late Show with Stephen Colbert” to weigh in on the revamped vaccine advisory group, calling its new members the “.”

President Donald Trump has defended Kennedy, telling reporters “he means very well,” even as Trump said on Sept. 5 that “you have some vaccines that are so amazing.” Trump has repeatedly expressed pride in Operation Warp Speed, a government initiative during Trump’s previous administration that rapidly developed covid vaccines. But he’s also promoted a discredited theory linking vaccines and autism.

The White House did not respond to a request for comment.

The Trump administration already narrowed recommendations for the covid vaccine despite no new safety risks with the shots, although medical societies are continuing to recommend them for most people. The gulf is expected to widen as the agency’s advisory group reviews on a number of pediatric vaccines.

Other groups are also trying to provide vaccine and public health guidance, driven in part by concerns that Kennedy and other federal health leaders will make policy decisions and statements not grounded in science. Kennedy has promoted claims that aluminum, used in many vaccines, is , despite a lack of evidence for the claims. A , in fact, found aluminum was not linked to chronic disease, but Kennedy said the study’s supplemental data indicated it caused harm. The journal that published the study .

Current and former CDC and HHS staffers, along with public health academics and retired health officials, have formed the National Public Health Coalition, a nonprofit to endorse recommendations and provide guidance on policy issues. They plan to partner with state and local health departments.

“A real benefit of the National Public Health Coalition is we are made up of current and former CDC and HHS folks, people who have deep knowledge of what government programs for public health look like, and what improvements are needed,” said Abigail Tighe, the group’s executive director.

Another new group is , which bills itself as a volunteer-led effort to raise awareness about vaccines. And the was launched in April by the University of Minnesota’s infectious disease center, to review evidence for medical societies on the safety and effectiveness of vaccines.

“We’re going to continue to help wherever we can to address misinformation,” said Osterholm, the center’s leader.

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The outbreak soon became the worst the United States has endured in over three decades.

In the month after Donald Trump took office, his administration Centers for Disease Control and Prevention communications, stalled the agency’s reports, its data, and abruptly staff. In the chaos, CDC experts felt restrained from talking openly with local public health workers, according to interviews with seven CDC officials with direct knowledge of events, as well as local health department emails obtained by ºÚÁϳԹÏÍø News through public records requests.

“CDC hasn’t reached out to us locally,” Katherine Wells, the public health director in Lubbock, Texas, wrote in a Feb. 5 email exchange with a colleague two weeks after children with measles were hospitalized in Lubbock. “My staff feels like we are out here all alone,” she added.

A child would die before CDC scientists contacted Wells.

“All of us at CDC train for this moment, a massive outbreak,” one CDC researcher told ºÚÁϳԹÏÍø News, which agreed not to name CDC officials who fear retaliation for speaking with the press. “All this training and then we weren’t allowed to do anything.”

Delays have catastrophic consequences when measles spreads in undervaccinated communities, like many in West Texas. If a person with measles is in the same room with 10 unvaccinated people, nine will be infected, . If those nine go about their lives in public spaces, numbers multiply exponentially.

The outbreak that unfolded in West Texas illustrates the danger the country faces under the Trump administration as vaccination , misinformation flourishes, public health budgets are cut, and science agencies are subject to political manipulation.

While the Trump administration stifled CDC communications, health secretary Robert F. Kennedy Jr. in vaccines and exaggerated to ward off disease. Suffering followed: The spread to , , , , and — at minimum. Together these have sickened more than 4,500 people, killed at least 16, and levied exorbitant costs on hospitals, health departments, and those paying medical bills.

“This is absolutely outrageous,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University. “When you’re battling contagious diseases, time is everything.”

‘The CDC Is “Stressed” Currently’

Wells was anxious the moment she learned that two unvaccinated children hospitalized in late January had the measles. Hospitals are legally required to report measles cases to health departments and the CDC, but Wells worried many children weren’t getting tested.

“I think this may be very large,” she wrote in a Feb. 3 email to the Texas Department of State Health Services. Wells relayed in another email what she’d learned from conversations around town: “According to one of the women I spoke with 55 children were absent from one school on 1/24. The women reported that there were sick children with measles symptoms as early as November.”

In that email and others, Wells asked state health officials to put her in touch with CDC experts who could answer complicated questions on testing, how to care for infants exposed to measles, and more. What transpired was a plodding game of telephone.

One email asked whether clinics could decontaminate rooms where people with measles had just been if the clinics were too small to follow the CDC’s recommendation to keep those rooms empty for two hours.

“Would it be possible to arrange a consultation with the CDC?” Wells wrote on Feb. 5.

“It never hurts to ask the CDC,” said Scott Milton, a medical officer at the Texas health department. About 25 minutes later, he told Wells that an information specialist at the CDC had echoed the guidelines advising two hours.

“I asked him to escalate this question to someone more qualified,” Milton wrote. “Of course, we know the CDC is ‘stressed’ currently.”

Local officials resorted to advice from doctors and researchers outside the government, including those at the , a Texas nonprofit.

“The CDC had gone dark,” said Terri Burke, executive director of the partnership. “We had anticipated a measles outbreak, but we didn’t expect the federal government to be in collapse when it hit.”

Technically, the Trump administration’s had ended Feb. 1. However, CDC scientists told ºÚÁϳԹÏÍø News that they could not speak freely for weeks after. 

“There was a lot of confusion and nonanswers over what communications were allowed,” one CDC scientist said.

Georges Benjamin, executive director of the American Public Health Association, said the situation was not unique to measles. “Like most public health organizations, we weren’t able to get ahold of our program people in February,” he said. Information trickled out through the CDC’s communications office, but CDC scientists gave no press briefings and went dark on their closest partners across the country. “The CDC was gagged,” he said.

Through private conversations, Benjamin learned that CDC experts were being diverted to remove information from websites to comply with executive orders. And they were afraid to resume communication without a green light from their directors or the Department of Health and Human Services as they watched the Trump administration CDC staffers in droves.

“It’s not that the CDC was delinquent,” Benjamin said. “It’s that they had their hands tied behind their backs.”

To work on the ground, the CDC needs an invitation from the state. But Anne Schuchat, a former CDC deputy director, said that during her 33 years with the agency, federal health officials didn’t need special permission to talk freely with local health departments during outbreaks. “We would always offer a conversation and ask if there’s anything we could do,” she said.

Lara Anton, a press officer at the Texas health department, said the state never prevented the CDC from calling county officials. To learn more about the state’s correspondences with the CDC, ºÚÁϳԹÏÍø News filed a public records request to the Texas health department. The department refused to release the records. Anton called the records “confidential under the Texas Health and Safety Code.”

Anton said the state sent vaccines, testing supplies, and staff to assist West Texas in the early weeks of February. That’s corroborated in emails from the South Plains Public Health District, which oversees Gaines County, the area hit hardest by measles.

“Texas will try to handle what it needs to before it goes to the CDC,” Zach Holbrooks, the health district’s executive director, told ºÚÁϳԹÏÍø News.

Responding to an outbreak in an undervaccinated community, however, requires enormous effort. To keep numbers from exploding, public health workers ideally would notify all people exposed to an infected person and ask them to get vaccinated immediately if they weren’t already. If they declined, officials would try to persuade them to avoid public spaces for three weeks so that they wouldn’t spread measles to others.

Holbrooks said this was nearly impossible. Cases were concentrated in where people relied on home remedies before seeking medical care. He said many people didn’t want to be tested, didn’t want to name their contacts, and didn’t want to talk with the health department. “It doesn’t matter what resources I have if people won’t avail themselves of it,” Holbrooks said.

Historically, Mennonites faced persecution in other countries, making them leery of interacting with authorities, Holbrooks said. A backlash against covid restrictions deepened that mistrust.

Another reason Mennonites may seek to avoid authorities is that some , having immigrated to Texas from Canada, Mexico, and Bolivia in waves over the past 50 years. the population of Seminole, the main city in Gaines County, is far larger than the count.

“I have no idea how many cases we might have missed, since I don’t know how many people are in the community,” Holbrooks said. “There’s a lot of people in the shadows out here.”

Public health experts say the situation in Gaines sounds tough but familiar. Measles tends to take hold in undervaccinated communities, and therefore public health workers must overcome mistrust, misinformation, language barriers, and more.

About 450 people — including local health officials, CDC scientists, nurses, and volunteers — helped control a measles outbreak sparked in an Eastern European immigrant community in , Washington, in 2018.

Alan Melnick, Clark County’s public health director, said his team spoke with hundreds of unvaccinated people who were exposed. “We were calling them basically every day to see how they were doing and ask them not to go out in public,” he said.

Melnick spoke with CDC scientists from the start, and the intensity of the response was buoyed by emergency declarations by the county and the state. Within a couple of months, the outbreak was largely contained. No one died, and only two people were hospitalized.

In , hundreds of people in the city’s health department responded to a larger measles outbreak in 2018 and 2019 concentrated among Orthodox Jewish communities. The work included meeting with dozens of rabbis and distributing booklets to nearly 30,000 households to combat vaccine misinformation.

The effort cost more than $7 million, but Jane Zucker, New York City’s assistant health commissioner at the time, said it yielded immense savings. The average medical bill for measles hospitalizations is roughly $18,500, according to . Then there’s the cost of diverting hospital resources, of children missing school, of parents staying home from work to care for sick kids, and of some measles infections, including .

“I don’t think there’s a price tag to put on a child’s death that would otherwise be prevented,” Zucker said.

Local health departments in West Texas were understaffed from the start. About 18 people work at the South Plains health department, which oversees four vast rural counties. About 50 staff the department in Lubbock, where patients were hospitalized and health workers struggled to figure out who was exposed. In mid-February, Wells emailed a colleague: “I’m so overwhelmed.”

A Death Ignites a Response

On Feb. 26, Texas announced that of measles. Wells heard from CDC scientists for the first time the following day. Also that day, the CDC issued a on the outbreak. The notice recommended vaccines, but it worried public health specialists because it also promoted vitamin A as a treatment under medical supervision.

In emails, Texas health officials privately discussed how the CDC’s notice might exacerbate : Doctors were with measles for toxic levels of vitamin A, suggesting that parents were delaying medical care and administering the supplements at home. A local Lubbock news outlet where vitamin A supplements and cod liver oil, which contains high levels of vitamin A, were “flying off the shelf.”

Too much vitamin A can cause liver damage, blindness, and during fetal development.

Milton worried that parents were listening to misinformation from anti-vaccine groups — including by Kennedy — that diminished the need for vaccination by that vitamin A staved off the disease’s worst outcomes.

“How many people will choose Vitamin A and not a vaccine because it appears to them there are two options?” Milton asked in an email.

Scientists at the CDC privately fretted, too. “HHS pressed us to insert vitamin A into all of our communications with clinicians and health officials,” one CDC scientist told ºÚÁϳԹÏÍø News, referring to the agency’s notices and alerts. “If pregnant women took too much vitamin A during the outbreak, their babies could be profoundly disabled. We haven’t seen those babies born yet.”

Another CDC official said they’ve had to “walk a fine line” between protecting the public based on scientific evidence and aligning with HHS.

While CDC scientists held their tongues, Kennedy exaggerated the power of nutrition and vitamin A while furthering mistrust in vaccines. “We’re providing vitamin A,” Kennedy said in an interview on . “There are many studies, some showing 87% effectiveness,” he claimed, “against serious disease and death.”

The were conducted in low-income countries where children are malnourished. Evidence suggests that vitamin A supplementation is against measles in the United States, because deficiency is exceedingly rare.

Kennedy deflected criticism from those who call him anti-vaccine, any parent in Texas who wants a measles vaccine can get one. He followed this with dangerously . “There are adverse events from the vaccine. It does cause deaths every year,” he said. “It causes all the illnesses that measles itself causes, encephalitis and blindness, et cetera.” There is that measles vaccines “cause deaths every year.” Scores of studies show that the vaccine encephalitis, that most potential side effects resolve quickly on their own, and serious adverse reactions are far rarer than measles complications.

In Kennedy said, “The MMR vaccine contains a lot of aborted fetus debris.” The measles, mumps, and rubella, or MMR, vaccine an iota of fetal cells.

HHS spokesperson Andrew Nixon and spokespeople at the CDC did not respond to queries from ºÚÁϳԹÏÍø News.

‘Staff Are Exhausted’

Despite national attention after the country’s first measles death in a decade, West Texas was overwhelmed. In late February and March, hospital administrators and health officials exchanged emails about how to lobby for resources.

“Local hospitals are at capacity,” wrote Jeffrey Hill, a senior vice president at the University Medical Center Health System in Lubbock. “The state reports emergency funds that typically cover a response like the measles outbreak are not available from the federal government right now,” he added.

“I am writing to express our urgent need for additional staff and funding,” Ronald Cook, medical director for Lubbock, said in an email, drafted with other Lubbock health authorities, to the deputy city manager. “Our Capacity is Stretched Thin: The health department has been operating seven days a week since February 2nd. Staff are exhausted.”

The city of Lubbock fronted money to help the local health department hire temporary staff. The state did not provide money, but it asked the CDC to send epidemiologists. Some came to Texas in early March. Then Texas requested federal funds.

None arrived, even as the outbreak approached 500 cases. It when an unvaccinated Mennonite child returned home after visiting family in Seminole. This would fuel the largest outbreak Mexico has seen , with at least 3,700 cases and in the state of Chihuahua.

Then another child in West Texas .

In a rare moment of openness, CDC scientist David Sugarman mentioned the outbreak at a vaccine in late April. “There are quite a number of resource requests coming in, in particular from Texas,” Sugarman said. “We are scraping to find the resources and personnel needed to provide support to Texas and other jurisdictions.”

Federal funds arrived in Texas on May 21, said Anton, the state health department spokesperson. By then, the crisis was fading. The outbreak seemed to have burned until every unvaccinated person in Seminole was infected, said Richard Eby, a doctor at Permian Regional Medical Center who treated some measles patients. Hundreds, if not thousands, of cases have probably gone undetected, he said. “A lot of people presumed their kids had measles,” he said, “and didn’t see the need to confirm it.”

On Aug. 18, health officials declared the West Texas , but the consequences of the catastrophe will be lasting.

The outbreaks it sparked across the U.S. and Mexico are still spreading.

More are inevitable, Nuzzo said. A growing number of parents are deciding their kids, worried over unfounded rumors about the shots. Misinformation is flourishing, especially after Kennedy fired vaccine experts who advise the CDC and replaced them with doctors and researchers on the fringes of the scientific establishment. For example, one of his recent appointees, Robert Malone, with measles on “medical mismanagement,” .

At the same time, states are downsizing programs for emergency response, disease surveillance, and immunization after the Trump administration clawed back more than in public health funds earlier this year.

Amid Lubbock’s toughest months, Wells sent an email to the department’s exhausted staff. “The future is uncertain, and I know this is an unsettling time for many of us,” she wrote. “Every day we show up and do our jobs is an act of resilience.”

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It had clawed back more than $11 billion in federal public health grants to states and abruptly terminated millions of dollars in funds for HIV work in the United States. Testing and outreach for HIV faltered in the South, a region that accounts for of all HIV diagnoses.

Dangerous changes loomed: To compensate for tax cuts for the wealthy, Trump’s “big, beautiful” bill and budget proposal for fiscal year 2026 threaten to curtail Medicaid, which provides health coverage for people with low incomes and disabilities. About rely on it for their lifesaving treatments.

Further, the budget at the Centers for Disease Control and Prevention. This alone could lead to an within the next five years, according to one analysis.

Trump’s budget proposal also would that provides housing assistance for people with HIV. And it would end a strategic initiative to expand HIV services in minority communities, and another to support the mental health of people of color with HIV or at risk of infection.

“President Trump is committed to eliminating radical gender and racial ideologies that poison the minds of Americans,” a White House addendum to the budget says. Letters terminating HIV grants used similar language, targeting “diversity,” “equity,” and “gender minorities,” words that focus resources where they are needed most. Black and Latino people of new HIV infections in the U.S.

The cuts affect Sturdevant personally. He is a gay, Black man living with HIV and the co-founder of a grassroots group that combats health disparities in the Mississippi Delta, one of the poorest regions of the country.

That morning at church, a close friend, pastor Jerry Shelton of Anointed Oasis of Love Ministry, asked Sturdevant to help him deliver a sermon about resisting the urge to give up when life is hard. “The storm may come, but I shall not be moved!” Shelton preached, directing the congregation to approach adversity with confidence in themselves and in God. “Walk boldly!” he shouted.

After the service, Sturdevant resolved to bring the same energy to Washington. He’d tell his colleagues that they are survivors, he said. He’d tell them, “Let’s get together and make a plan.”

In the past few months, HIV advocates have begun to organize and strategize ways to limit the damage as federal funds are slashed and rises.

“It is a very scary time to be Black, queer, and living with HIV,” said Marnina Miller, co-executive director of the , a nationwide group for women living with HIV. “But I am grateful that I am part of a community that will not bow down.”

“People are not giving up,” said June Gipson, the CEO of a health care nonprofit, , in Mississippi. Then she referenced the where heroes combine forces to create a super robot to defend the universe:

“We’ve got to form Voltron.”

The Weight of Stigma

Sturdevant often reminds his colleagues of all the HIV movement has overcome. In the 1980s, the government refused to acknowledge HIV as gay men died young. Once powerful treatments were available in the 1990s and early 2000s, the public health establishment with HIV, especially in the South. In that period, the demographics of the epidemic shifted away from white, upper- and middle-class gay populations in liberal states. today are in the South and a third are among people with low incomes.

When Sturdevant first tested positive for HIV in 2005, he didn’t seek treatment. He kept his diagnosis hidden from friends and family because he knew how people talked about HIV. They considered it a death sentence, a punishment for irresponsible behavior, or a disease that could infect them through a touch or a shared toilet seat — which it cannot.

“I thought my family was going to disown me,” he said.

A year later, his weight plummeted because he couldn’t hold down food or water. Gaunt and feverish, he went to the hospital and learned he had AIDS. His mother slept at his hospital bedside for two weeks: “She said, ‘God got you.’”

Once he regained his health, Sturdevant resolved to care for others in his position. Scientists had developed powerful HIV drugs that, if taken daily, transform it from a death sentence into a in which a person’s virus levels are so suppressed that they cannot spread HIV to others. And policymakers ensured that almost everyone in the U.S. with HIV could get treated regardless of their ability to pay, largely because of Medicaid and the Ryan White HIV/AIDS Program.

But HIV experts had failed to overcome a key problem: of people living with HIV in the U.S. don’t get treated or don’t take the drugs regularly enough to be virally suppressed. Viral suppression rates are better in many than in America.

To seek treatment and stick with it, Sturdevant understood, people had to have basic needs like food and housing met and, as importantly, a sense of belonging and empowerment. At his first job at an HIV organization in Jackson, Mississippi, Sturdevant regularly checked in with clients who didn’t have family members to support them. He hosted gatherings at his apartment and even offered it up as a place to stay. He has taken on the role of dad or uncle to many. “We called ourselves the family of love,” he said.

He saw how care bolstered lives, but the federal government needed data to drive its approach to HIV.

In 2012, the CDC expanded its in-depth surveys to learn more about the lives of people at risk of HIV and of those with HIV who weren’t virally suppressed. The surveys revealed what Sturdevant knew: A disproportionate number of them grappled with unstable housing, food insecurity, depression, and anxiety. Many participants agreed to prompts like, “Having HIV makes me feel that I’m a bad person,” or “Most people think that a person with HIV is disgusting,” or “Most people with HIV are rejected.”

The data showed policymakers that to curb the epidemic, they needed to address underlying problems that people with HIV faced. Federal funds began to flow to grassroots groups embedded in marginalized communities.

Public health researchers folded Black churches into the effort, recognizing them as hubs of volunteerism and as leaders of social movements. Although churches in the U.S. had historically fueled stigma against sexually transmitted diseases, Amy Nunn, a public health researcher at Brown University, said every pastor she talked with was eager to help. It . In Kansas City, for example, that congregants who went to Black churches involved in HIV education and outreach were more than twice as likely to be tested.

Community-based interventions worked: New HIV infections dropped by 12% from 2018 to 2022.

Now the grassroots groups that have been so effective are in jeopardy and the in-depth surveys have halted as the Trump administration cuts funds and lays off CDC staff. Some health departments have issued stop-work orders to community-based groups that test people for HIV and connect them to treatment because federal HIV grants are unusually delayed. And as the Department of Health and Human Services continues to cancel HIV grants, the directors of grassroots groups anticipate more cuts.

“A lot of them are new and don’t have the resources to survive a year without funding,” said Masen Davis, executive director of Funders Concerned About AIDS.

One such group is Sturdevant’s.

‘Trust the Process’?

In 2017, Sturdevant returned home to the Mississippi Delta to launch a nonprofit, , in one of the poorest and most medically underserved parts of the country. The , a decade shorter than the national average. The disenfranchisement of its majority-Black population stems from the region’s history, in which policies concentrated wealth and power among the minority-white population during the era of cotton sharecropping, Jim Crow laws and segregation, and, recently, .

Sturdevant set up shop in Greenville, near a Black church that served as a activists in the 1960s. In a small office, his team organizes health events, tests people for HIV, and connects those who test positive with treatment and housing assistance, funded through federal programs like Ryan White.

“Whites have been getting Ryan White and other programs for years and living healthy,” said Ashley Richardson, administrative assistant of Sturdevant’s group. “Around here, Black people are just now getting to the point where we know there are resources to help.”

Lately the team fields calls from people with HIV who are terrified they will lose their lifesaving drugs and housing if government programs no longer help with the cost.

Sturdevant worries about keeping his staff employed and his community safe. On the drive home from the April event in Washington, he drearily recounted conversations with Republicans in Congress: “They basically all said trust the process.”

The heads of national HIV organizations have stepped up their advocacy, asking Congress to oppose cuts in President Donald Trump’s budget request, said Gregorio Millett, director of public policy at the Foundation for AIDS Research, a nonprofit known as amfAR.

Emily Hilliard, spokesperson for the Department of Health and Human Services, responded to queries from ºÚÁϳԹÏÍø News by writing, “Critical HIV/AIDS programs will continue under the Administration for a Healthy America.” Yet the administration’s proposed budget for HIV prevention represents a 78% reduction compared with fiscal year 2025, according to

HHS Secretary Robert F. Kennedy Jr. has fostered skepticism  about scientific facts concerning HIV, without citing evidence. “Any questioning of the orthodoxy that HIV is the sole cause of AIDS remains an unforgivable-even dangerous-heresy among our reigning medical cartel,” he wrote in a 2021 book.

Not Bowing to Barriers

Researchers and HIV advocates are hashing out strategies to fill in the vacuum in HIV care that the government is poised to leave. For decades, it has driven priorities, coordinated a constellation of HIV groups, and tracked the epidemic. Leisha McKinley-Beach, CEO of a training institute, Black Public Health Academy, in Atlanta, said people must remember that wasn’t always the case.

“This massive industry we have today was created by committed individuals at the grassroots level, who were going to help people live with HIV or die with dignity, by any means necessary,” she said.

One idea is to have larger, established HIV organizations partner with nascent groups in underserved regions. The bigger ones stand a better chance of garnering significant private donations. And by taking on the fiscal management of grants, large groups could enable small ones to devote time to service rather than fundraising, McKinley-Beach said.

Another strategy, said Kathy Garner, executive director of Mississippi’s , is to fill gaps by coordinating with churches and nonprofits dedicated to food assistance, housing, or mental health.

“One of the solutions is going to be civil society stepping up,” Garner said. “That’s an old term for people taking care of each other, outside of the government.”

“We’re going to need to ramp up our services in all kinds of ways, and health and HIV will be a part of that,” said Bishop Ronnie Crudup of New Horizon Church International in Jackson, and a member of Mississippi Faith in Action, a coalition of African American churches involved in HIV.

“I have real concerns with what the Trump administration is doing, and how it will play out for the health of people in a poor state,” he said.

National groups, such as AIDS United, have been speaking with corporate funders and philanthropies about building a pooled fund to help sustain HIV organizations across the U.S.

Philanthropy for HIV has never come close to matching federal dollars, however. Non-governmental funders put $284 million toward HIV in the U.S. in 2023, compared with about for HIV in recent years.

“The truth is there is no way for philanthropy to make up for the cuts from the federal government,” Davis said. “I suspect we will see new infections rise within 18 months, which is heartbreaking.”

Sturdevant focuses on survival, not forecasts. “This isn’t going to be easy,” he said, “but we need to keep fighting for those who don’t have the fight in them.”

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The researchers were laid off in early April, just before they put the finishing touches on in-depth, national surveys about HIV. Health officials across the country had interviewed tens of thousands of people at risk of acquiring HIV, or who are living with the virus, and compiled information from mountains of medical records.

States and cities were prepared to submit the information they collected to the CDC in April so the agency’s statisticians could prepare the volumes of data for analysis.

Health officials and policymakers use the data to design HIV programs that more efficiently curb the spread of infections and save lives. For example, a revealed that about half of adults under age 30 who were living with HIV weren’t on treatment steadily enough to keep them healthy and prevent them from spreading the virus to others. Treatment rates were far higher for those over 50. As a result, health officials doubled down on outreach to younger generations.

However, in April, state and local health officials found themselves cut off from their CDC counterparts after the layoffs. Emails from the Department of Health and Human Services told staff their roles were “either unnecessary or virtually identical to duties being performed elsewhere in the agency.”

Marti Merritt, a project coordinator at the Illinois state health department, was flabbergasted that she and other state employees had invested more than a year into the surveys only to have them go dark in the final phase. “It’s like the data has gone into a black hole,” she said. “How do you set priorities if you don’t have data?”

Merritt worries that if the surveys don’t resume, limited budgets will be misspent — and that cases will rise. Data allows health departments to tailor their efforts to the populations at greatest risk of infection or disease progression.

Evidence shows that preventing HIV is far cheaper than treating people once they’re infected. Preventing one HIV infection results in . Merritt was also dismayed to have wasted the time of thousands of people who opened up about intimate details of their lives in hopes of fighting the HIV epidemic.

A doctor and HIV expert reinstated at the CDC this week said the late termination of the surveys would waste millions of taxpayer dollars that have already been spent on data collection. Two large, long-standing efforts, the Medical Monitoring Project and the National HIV Behavioral Surveillance system, cost around $72 million, he said.

“Two years’ worth of data from 30,000 participants will be unusable, and therefore wasted,” if the projects can’t be finished, he said.

To resume the surveys, he and other CDC researchers would need a green light from higher up because the grants covering these surveys ended while they were on administrative leave in May.

State health officials said they haven’t received the CDC notices that typically renew the surveys every June. Merritt has conducted interviews for the Medical Monitoring Project for about 20 years, she said, but the Illinois health department has now assigned her to other tasks. Other health departments have or reassigned employees dedicated to HIV surveillance, too.

If HHS allows the reinstated researchers to resume the projects, they could try to account for the 10-week gap in their analysis. But it would take time, further delaying the next round of surveys — if those begin at all.

“These surveys aren’t lights that you turn on and off,” said John Brooks, a researcher who retired from the CDC’s Division of HIV Prevention last year. If the surveys resume, he said, “we can get some value out of all of the money spent.”

However, the surveys would be further impaired by actions related to Trump’s executive orders targeting words such as “gender” that researchers use to learn who has HIV, who is at risk, and why.

Experts at the CDC said they’ve already had to revise earlier surveys and recalculate results to not reference gender. This has meant altering data on two populations disproportionately affected by HIV: transgender people and men who have sex with men.

“To erase people from our data harms them,” said the researcher and doctor now reinstated at the CDC. “I care about the transgender patients I see, and it’s so hurtful to see them treated this way by the government.”

The doctor said he has treated HIV patients since the beginning of the epidemic in the 1980s, and the sting he feels now is worse than under President Ronald Reagan, who never publicly mentioned HIV in his first term.

“There was a lack of funding,” he said, “but they didn’t censor science or try to control science like they’re doing now.”

Many HIV researchers have taken jobs outside the government or moved since the April layoffs. Some researchers returning to the agency called the reinstatements perplexing because the notices don’t say what they’ll be doing when they return and for how long.

A terse email to CDC employees from Tom Nagy, chief human capital officer at the Department of Health and Human Services, reviewed by ºÚÁϳԹÏÍø News, simply refers to the notice regarding the reduction in force and says, “That notice is hereby revoked.”

In an email response to queries, Andrew Nixon, HHS director of communications, wrote, “HHS is streamlining operations without compromising mission-critical work. Enhancing the health and well-being of all Americans remains our top priority.”

“We’ve been getting paid this whole time even though we’ve not been allowed to work, and that doesn’t feel good when you’re a dedicated civil servant,” said one reinstated employee.

We’d like to speak with current and former personnel from the Department of Health and Human Services or its component agencies who believe the public should understand the impact of what’s happening within the federal health bureaucracy. Please message ºÚÁϳԹÏÍø News on Signal at (415) 519-8778 or .

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