He was a chiropractor by training, but in a remote part of West Texas with limited medical care, Kiley Timmons had become a first stop for whatever hurt. Ear infections. Labor pains. Oil workers who arrived with broken ribs and farmers with bulging discs. For more than a decade, Kiley, 48, had seen 20 patients each day at his small clinic located between a church and a gas station in Brownfield, population 8,500. He treated what he could, referred others to physicians and prayed over the rest.
It wasn’t until early this spring that he started to notice something unfamiliar coming through the door: aches that lingered, fevers that wouldn’t break, discolored patches of skin that didn’t make sense. At first, he blamed it on a bad flu season, but the symptoms stuck around and then multiplied. By late March, a third of his patients were telling him about relatives who couldn’t breathe. And then Kiley started coughing, too.
His wife, Carrollyn, had recently tested positive for Covid, but her symptoms eased as Kiley’s intensified. He went to a doctor at the beginning of April for a viral panel, but every result came back negative. The doctor decided to test for the remote possibility of measles, since there was a large outbreak spreading through a Mennonite community 40 miles away, but Kiley was vaccinated.
“I feel like I’m dying,” Kiley texted a friend. He couldn’t hold down food or water. He had already lost 10 pounds. His chest went numb, and his arms began to tingle. His oxygen was dropping dangerously low when he finally got the results.
“Positive for measles,” he wrote to his sister, in mid-April. “Just miserable. I can’t believe this.”
Twenty-five years after measles was officially declared eliminated from the United States, this spring marked a harrowing time of rediscovery. A cluster of cases that began at a Mennonite church in West Texas expanded into one of the largest outbreaks in a generation, spreading through communities with declining vaccination rates as three people died and dozens more were hospitalized from Mexico to North Dakota. Public health officials tracked about 1,200 confirmed cases and countless exposures across more than 30 states. People who were contagious with measles boarded domestic flights, shopped at Walmart, played tuba in a town parade and toured the Mall of America.
But what frightened Kiley more than the potential spread was the severity of the disease: About one in five unvaccinated people with measles will be hospitalized, according to the Centers for Disease Control and Prevention. As many as one in 20 children contracts a secondary pneumonia infection. More than one in 1,000 dies. Measles stops spreading when 95 percent of a community is immune, but national vaccination rates for children have fallen to less than 92 percent. In parts of West Texas, they’ve dropped below 80.
Kiley’s business catered in part to patients who were skeptical of mainstream American health care and wanted to try alternative treatments. “The doctor of the future will give no medicine,” read one sign that he hung in his office. A former farmer, he believed in caring for everyone in his hometown — even if that meant sometimes taking payments in the form of a haircut, a used gun, a dishwasher or unpasteurized cheese from a member of the Mennonite community. Most of what he remembered about measles came from an old “Brady Bunch” episode, where the children celebrated staying home from school and played board games. “If you have to get sick, sure can’t beat the measles,” one of the children said.
“I feel like I’ve been lied to,” Kiley told his wife as his fever rose to 104 degrees. He tried to manage his symptoms at home with cod liver oil and vitamin D, supplements endorsed by Robert F. Kennedy Jr., the U.S. health secretary. He isolated himself in the living room to avoid infecting his four children and coughed and dry-heaved his way through the night.
“I’m just trying to breathe at the moment,” he texted one relative.
One morning about a week into his illness, Carrollyn walked into the living room and saw Kiley lying on the couch. His head was almost purple. A rash was blooming across his chest, and his mouth was dotted with dozens of white sores. She tested his oxygen level. It read 85 percent — low enough to endanger his vital organs. She tucked the monitor away to keep Kiley from panicking. He was hazy and confused, so she helped him into a fresh shirt and drove him to the emergency room, where he was quarantined and given oxygen, breathing treatments and X-rays to monitor his stomach cramps.
He stayed in isolation for the next 40 hours, too sick to rest and too exhausted to talk, until he rolled over and saw a new message on his phone, from Carrollyn.
“Update on the kids,” she said, in the second week of April. “Three of them have fevers.”
For more than a decade, Kiley and Carrollyn had debated whether to vaccinate their children. Each time, they decided against it.
The vaccine was considered both safe and 97 percent effective by the Food and Drug Administration. For generations, every credible American health official had recommended the M.M.R. vaccine, to prevent measles, mumps and rubella, as a basic obligation to society. Almost all parents in Texas had consented to the recommended two doses for their children, effectively eliminating measles transmission within the United States. But that success also meant the disease had gradually become an abstraction, a distant threat. Only three Americans had died of measles since 2000, and Kennedy rose to political prominence as a vaccine skeptic. He testified to Congress about the risk of rare vaccine injuries, and later fired all 17 experts on a vaccine advisory panel. “People ought to be able to make the choice for themselves,” he said in a March interview on Fox News.
In recent years, as many as 15 percent of families in West Texas school districts had applied for “conscientious exemptions” from the M.M.R. vaccine. What Carrollyn feared more than measles was the remote possibility that her children might experience an adverse reaction to the shots. Two of her younger siblings had been vaccinated and had then suffered from high fevers that led to febrile seizures — scary convulsions that lasted several minutes but didn’t cause permanent damage.
“My children won’t see this disease in their lifetimes,” she always concluded. “The vaccine would probably be fine, but why take an unnecessary risk?”
She worked to safeguard the children in other ways when she first heard about the cluster of cases in nearby Gaines County. Measles is among the most contagious diseases, with one person infecting an average of about 15 others in a population without immunity, and soon there were more than 300 confirmed cases across West Texas. Carrollyn stopped taking the children to the grocery store and stocked up on immune supplements that were soon featured in every Texas checkout lane. She and Kiley talked again about the possibility of vaccinating — and landed on the same decision. The children were young, healthy, strong. Maybe they still wouldn’t get it.
Arden, 9, was the first to spike a fever, and it continued for 13 days. Then Garner, 12, started throwing up. By the time Kiley was sent home from the hospital, their 14-year-old twins, Hudson and Tucker, were also declining, and Carrollyn was setting alarms on her cellphone every hour to distribute Tylenol and check oxygen levels.
“I’ve never seen people this sick,” Carrollyn wrote to a friend. “We must be hitting the peak. Everyone is awful today.”
Hudson’s oxygen levels started to crash on Easter weekend, and Carrollyn decided to drive him to the hospital. She helped him out of bed, but he barely had strength to stand. His legs wouldn’t stop shaking. His vision blurred. Kiley tried to help him down the hallway, but Hudson couldn’t make it. He slumped forward, fading in and out of consciousness. Carrollyn rushed to grab him a chair and dialed 911. A few minutes later, she was riding with Hudson in the back of an ambulance on the way to Lubbock, 45 minutes away. Carrollyn called Kiley to check on the other kids.
“We’re right behind you,” Kiley told her. “Nobody’s doing well. I’m taking them all to the E.R.”
All four children were eventually admitted and then quarantined. Carrollyn and Kiley split into different rooms, texting back and forth, tracking the children’s symptoms and trying to figure out who was faring the worst. Hudson was struggling to breathe while sitting in a wheelchair, and his oxygen had dropped into the low 80s. His brother, Tucker, was dehydrated with a 103-degree fever while curled up on a metal chair. Arden had pneumonia and a fever of 105.
“They’re putting Arden on oxygen now,” Kiley wrote.
“Garner is bad,” Carrollyn texted back. “Bloody nose and throwing up at the same time. I just cried with him.”
“Hudson’s oxygen is dropping when he sleeps,” Kiley wrote. “Tucker needs some fluids. Just completely lethargic.”
“I’m done with this crud,” Carrollyn wrote.
It took three days before all of them were stable enough to return home, and even then, their recovery wasn’t complete. Kiley continued to suffer from temporary hair loss, brain fog and short-term memory deficits. The children had cluster headaches. And then came a new wave of symptoms: eye sores, muscle aches and colds from what seemed like a new round of viruses. Kiley researched online and read that measles can cause a condition called “immune amnesia,” leaving the body vulnerable to all kinds of other infections for months or even years.
He and Carrollyn scheduled a follow-up appointment for the family with a doctor in Lubbock named Ben Edwards, who had seen more measles cases in the last few months than any American in two decades. Edwards was being celebrated for his response to the outbreak, but also blamed for enabling its spread.
“Can you help us figure out what’s going on?” Kiley asked.
Edwards had never seen a measles case until earlier this year, but he’d helped vaccinate hundreds of children against the virus. He spent the first decade of his career as the only doctor in rural Garza County, Texas, practicing medicine in the same tradition as his grandfathers. “I was 100 percent by the book, just following the company line,” he said, which meant he saw patients in 10-minute blocks, recommended all vaccines on schedule and kept prescribing more medications to a population that seemed to only get sicker.
It wasn’t until 2011 that Edwards experienced what he called a “divine appointment,” and began questioning the core tenets of American medicine. He came to believe that his patients weren’t suffering from diseases so much as experiencing symptoms of bad diets and societal rot, and that the human body was almost always capable of healing itself with hydration, movement, nutritious foods and spiritual peace. He moved to Lubbock and started his own practice, Veritas Medical, named after the Latin word for truth. He began selling supplements and started a weekly podcast, “You’re the Cure,” on which he often hosted guests who questioned the safety of vaccines.
Instead of seeing 50 patients a day, Edwards scheduled his intake appointments for up to two hours, so he could learn about the root causes of his patients’ problems and offer dietary plans and what he called “peace consultations.” His new practice filled with hundreds of patients who shared his disillusionment with mainstream medicine, including a few dozen Mennonites who lived an hour from Lubbock.
One of them, Tina Siemens, called Edwards in early March and asked if he could attend the viewing of a child who had just died of complications from measles — the first American death from the disease in more than a decade.
“A lot of people are very sick and very scared,” she said. “Can you help us?”
Edwards loaded his pickup truck with supplements and drove to a small church outside Seminole, Texas. A 6-year-old girl with braided pigtails was lying in a coffin. Her four young siblings sat nearby, flushed with fevers, rashes and coughs.
Their parents were afraid to take them to the hospital, where their daughter had died a few days earlier in the intensive care unit. There is no antiviral treatment or cure for measles, so Edwards offered the children supportive care in the form of hydration, immune supplements and cod liver oil rich with vitamin A, which the World Health Organization recommends in some cases.
Edwards sat with the family and watched as more Mennonites rotated through the viewing, including many unvaccinated children with rashes and high fevers. “It was a whole lot of measles,” he said. “These kids were sick.”
Soon, dozens more families were asking Edwards for help. Seven siblings under 10, all fighting the virus inside a small farmhouse; a child who had been waiting for treatment in a car outside the emergency room; twin 4-month-olds, including one who was lethargic and glassy-eyed, struggling to breathe with an oxygen saturation in the low 70s. Even what Edwards came to see as a typical case was often nasty — coughing, stomach distress, dehydration and fevers that peaked as high as 104.
“This was not the measles I read about in the textbooks,” Edwards said. “The respiratory part was more than I was expecting.”
He drove to a pharmacy in Lubbock for an inhaled steroid called budesonide, which can reduce inflammation in the lungs, and the 4-month-old began to improve the next day. Edwards offered to volunteer his time by opening a free weekend clinic in Seminole, and he arranged to fly in 1,700 pounds of cod liver oil from Arizona on a private plane and told a dozen Mennonite pastors to send over any sick children in their congregations.
Over the next several weeks, Edwards made home visits and cared for as many as 300 people with measles, continuing to see patients even as he suffered a mild breakthrough infection and developed a rash himself. He conferred about supportive care methods with the C.D.C. and spoke privately with Kennedy, who shared his hesitations about the M.M.R. vaccine and praised Edwards in interviews as an “extraordinary healer.”
Most of Edwards’s patients showed some initial improvement with supportive care — which is what he offered to Kiley and his family as they began to recover. He gave all four children intravenous fluids and vitamins to bolster their immune systems for the weeks and months ahead. Edwards also continued to prescribe breathing treatments for patients in more severe distress, which sometimes helped ease their symptoms.
And all the while, Edwards continued to release his weekly podcast, hosting a rotation of authors, doctors and activists who minimized the danger of measles and spoke instead about the benefits of being unvaccinated and the risks of rare vaccine injuries.
“The body’s designed to kill measles,” Edwards said, as it spread into New Mexico and Oklahoma.
“I would encourage you to seek a higher authority, a spiritual authority, and let peace guide you,” he said, as the disease stretched into Kansas and Nebraska.
“Don’t be scared of anything,” he said, when the total number of reported measles cases rose above 1,000, almost all among people who were unvaccinated, as the virus continued to spread in Colorado, Pennsylvania and finally into the remote corners of North Dakota, arriving in the state for the first time in 14 years.
Lynn Douglas had been monitoring the outbreak in Texas and updating her staff on the northward spread of measles for several weeks, even though she doubted the virus would ever make its way into the Williston Basin School District, near the oil fields of North Dakota. The virus tended to die out in warm weather. It was already May, and the academic year was almost over. Douglas, the district’s nursing director, was more preoccupied by the daily line of students outside her office with colds, menstrual cramps, paper cuts and headaches, until a student showed up at an elementary school with a nasty cough and a rash.
Three other children in the same family were also sick, and the district sent them home for viral tests. A while later, Douglas received an email from the state’s health department.
“We have four positive cases that are associated with the schools,” it read.
Douglas and her staff met that evening with local health officials to plan their response to the state’s first measles outbreak since 2011. The district had almost 6,000 students, and the contagious children had been inside the high school, the middle school and one of the elementary schools. Douglas went over floor plans, class lists and seating charts, assessing the risk of contamination even as the virus had already threaded invisibly through the halls.
Anyone seated within 10 feet of a sick student could have been directly infected by a cough or a sneeze. Anyone sharing the same room was susceptible to particles that traveled by air and could enter the body through the mouth, nose and eyes. Anyone who came into the same room later in the day could also have been exposed, since the virus can live on surfaces and in the air for up to two hours.
Health officials mentioned one measles study, from the Special Olympics in 1991, in which a sick athlete on the field managed to infect two fans seated in the upper deck.
“Everyone in those three schools needs to be considered exposed,” Douglas said.
Her concern was mostly for unvaccinated students with no protection against the virus, and that number had been rising steadily for the last several years, making the district “vulnerable to outbreaks,” Douglas wrote to colleagues. All public schools in the U.S. allow some medical exemptions from mandatory vaccines like M.M.R. But, in the last 20 years, North Dakota and more than 40 other states have passed laws creating other allowances. More than 97 percent of Williston Basin’s 11th graders were fully vaccinated — enough for strong herd immunity. That percentage dropped to 95 percent for seventh graders, less than 90 percent for second graders, and a record low 81 percent for kindergartners.
North Dakota code required unvaccinated students to isolate for 21 days after a school exposure to prevent further spread. Douglas and her team searched through records and found 188 students whose parents had filed the necessary paperwork.
“Medically exempt.”
“Religiously exempt.”
“Philosophically exempt.”
“Measles is a serious disease,” Douglas wrote, in a letter to the families of the 188 students, informing them that they needed to stay home for three weeks. “Quarantine means they should not attend social events, parties, restaurants, church, sporting events, etc. Your cooperation with this is crucial to limiting the spread.”
Then, she waited. It can take up to two weeks from the point of infection for measles to become symptomatic. Five days went by with no new cases. Then eight. “We might have contained it,” she told the superintendent on the 11th day, a few hours before the health department called to announce a new positive case among the quarantined students.
The next day brought another new case. Then two more. Health officials warned of potential new exposures at Walmart and Tractor Supply. Over the next week, the number of local cases doubled, and the virus spread across the state into Fargo. In the last week of the school year, Douglas called a meeting to update her nursing staff.
“We have 13 cases right now,” she said.
“I’ve sent seven more to get tested,” another nurse said. “Probably just colds. Hopefully just colds.”
“I had a student coughing all over my office,” another nurse said. “I have a 2-year-old at home who can’t be fully vaccinated yet. I was kind of spiraling.”
Douglas apologized and checked a message on her phone. It was from the superintendent’s office, and she read it out loud.
“Three more potential cases,” she said. “This is a half-hour ago.”
She looked at her notes and added up the latest case numbers. Just a few weeks earlier, she’d been reading about the first deaths and a surge of hospitalizations in West Texas — a crisis that seemed to belong to a different era and a place far away.
The other nurses looked at her, awaiting direction.
“It’s still spreading,” Douglas said. “I’m starting to think this thing has come back to stay.”
Erin Schaff contributed reporting.
Eli Saslow writes in-depth stories about the impact of major national issues on people’s lives.
Erin Schaff is a photojournalist for The Times, covering stories across the country.
The post ‘I Feel Like I’ve Been Lied To’: When a Measles Outbreak Hits Home appeared first on New York Times.
