A New Mexico resident who has died, tested positive for measles, the state health department said on Thursday, marking the second measles-related death in the United States in more than a decade.

The unvaccinated adult patient did not seek medical care before death and was the first measles-related death in the state in more than 40 years, according to David Morgan, Public Information Officer for the New Mexico Department of Health.

The cause of death is still under investigation by the state medical examiner, Morgan said.

The death brings to 10 the number of measles cases that occurred in Lea County, located adjacent to Gaines County, Texas, where more than 100 cases and one death in an unvaccinated child have been reported.

The outbreak, one of the largest the United States has seen in the past decade, has put U.S. Health Secretary Robert F. Kennedy Jr, a longtime vaccine skeptic, to the test.

In a Cabinet meeting last week, Kennedy initially downplayed news that a school-aged child had died of measles, calling such outbreaks ordinary and failing to mention the role of vaccination to prevent measles.

Over the weekend, Kennedy published an opinion piece on Fox News that promoted the role of vaccination, but downplayed the role of vaccines by telling parents vaccination was a personal choice and urging them to consult with their physician.

He also stressed the role of vitamin A, overstating evidence for its use, which has only been shown to decrease measles severity in developing countries among individuals who are malnourished and vitamin A deficient, said Dr. Paul Offit, an infectious diseases expert at Children’s Hospital of Philadelphia.

“It’s not clear to me that’s true in the developed world, where vitamin A malnutrition is uncommon,” he said.

As of Feb. 27, 164 measles cases have been reported to the U.S. Centers for Disease Control and Prevention in nine jurisdictions: Alaska, California, Georgia, Kentucky, New Jersey, New Mexico, New York City, Rhode Island, and Texas.

Measles typically kills one to three people per 1,000 cases, said Dr. Tina Tan, an infectious disease expert at Northwestern University in Chicago.

She said two deaths out of a total of 164 cases suggest “a much higher mortality rate than we would normally see,” adding that there are probably many undetected cases.

The cases in New Mexico included six adults and four children under the age of 17. Seven of these cases were unvaccinated, while the vaccination history of the remaining three was not yet known.

The Department of Health and Human Services spokesperson Andrew Nixon said the Centers for Disease Control and Prevention is closely monitoring the situation and in communication with state health authorities. “CDC recommends vaccination as the best protection against measles infections,” he said.

New Mexico’s health department said it will host two community vaccination clinics on March 11. 
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