Politics

Local public health agencies also suspect that additional cases are occurring but those who are infected are not seeking testing or medical care, says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota in Minneapolis. “It’s very likely that the outbreak is larger than it is right now,” Osterholm says, “but how much larger we just don’t know.”

Complicating matters, in late March the Trump administration abruptly terminated funding to support local testing for measles and other infectious diseases and for staff to track outbreaks and give vaccinations.

In addition, jobs at the CDC, which provides expertise for state and local health departments facing such crises, have been cut as part of a massive restructuring plan for the U.S. Department of Health and Human Services.

The agency has deployed teams to Texas to assist with the outbreak. But more broadly, those job losses are an “unrecognized, catastrophic tsunami that’s going to sweep through public health,” Osterholm says. State and local governments have made minimal investments in public health, ceding responsibility to the CDC. “The reliance on federal support has left us highly vulnerable” to measles and other contagious diseases and to future pandemics, he says.