| It’s been five days since the last positive measles infection in Lubbock County, Texas, according to a whiteboard in the local health department. That’s the longest streak so far this year. Texas has seen an explosion of measles this year with a total of 718 infections so far. But on May 16, the state reported just one new measles case. According to the US Centers for Disease Control and Prevention, one to three in 1,000 people with a measles infection will die from complications. The US now has more than 1,000 infections this year, and three people have died, including two unvaccinated children in Texas. Texas’ measles decline is partially explained by an increase in vaccinations in the state and immunity built in the unvaccinated communities, said Lubbock’s public health director Katherine Wells. But the state isn’t declaring victory yet. There’s a possibility some positive cases for the contagious virus could slip through the cracks.  A measles advisory at a courthouse in Seminole, Texas. Photographer: Brandon Bell/Getty Images The true number of infections isn’t known, the Texas’ health department says, as not everyone who gets sick reports this to authorities. The Texas outbreak has centered on the unvaccinated and largely homeschooled community of Low German Mennonites in the rural west area of the state that favor medical freedom over vaccinations. Local health officials worked to create messaging about the virus and the vaccine in their language to reach the community, Wells said. The community is less likely to seek medical care, too. Hector Ocaranza, El Paso’s medical director, said the county has had issues with contact tracing among the unvaccinated communities. Some people who have vaccine exemptions won’t answer the phone, report a measles infection or seek medical attention, he said. “That makes it difficult for us to see the full magnitude of the outbreak,” he added. And budget constraints have created extra hardships for already-strained rural health departments. In rural Ector County, public health director Brandy Garcia said she lost three people from her staff of about 20 due to federal cuts to local health funding. It placed a strain on her one epidemiologist to conduct all of the measles contact tracing through the height of the outbreak. According to the state health department, 42 days need to pass with no new infection for the outbreak to be declared over. The state is eyeing early July as its victory date if the rate of infections continues its retreat. — Jessica Nix | 
