Six young children at a Lubbock, Texas, day care center have tested positive for measles — a dreaded scenario with the potential to accelerate an already out-of-control outbreak that has spread to at least two other states, NBC News reported. More than a dozen other states and Washington, D.C . are dealing with cases of measles unrelated to Texas. On Friday, the Texas Department of State Health Services said the toll rose to 481 confirmed cases, a 14% jump over last week. Fifty-six people have been hospitalized in the area since the disease started spreading in late January. At the Tiny Tots U Learning Academy, a center with approximately 230 infants, toddlers and preschool-age children, the outbreak began on March 24, when a little girl who had been sick with fever and vomiting tested positive. She later needed to be hospitalized for pneumonia and trouble breathing. Kids who have tested positive at the day care so far are between the ages of 5 months and 3 years old, said Maegan Messick, a co-owner of the center. None was fully vaccinated against measles. For nearly two weeks, Messick has been working with local health officials who are in contact with the Centers for Disease Control and Prevention about the situation. Messick said she’s not been given clear guidance on how to handle measles in such a large day care with so many vulnerable kids. “From what I’m being told, the CDC doesn’t have a playbook for this,” Messick said. “We’ve just had to make judgment calls.” The U.S. is facing the largest measles outbreak in six years, but the CDC has remained relatively silent on the public health threat, providing just weekly updates on its website and sending an alert to doctors last month. The agency sent 2,000 doses of the MMR vaccine to Texas health officials at their request, but hasn’t held a news briefing about measles since 2019, when two large outbreaks in New York threatened to reverse the United States’ status of having eliminated the virus. A spokesperson for the Department of Health and Human Services, which is over CDC, did not respond Friday to a question about whether any briefings were in the works to address the current measles outbreak. It was unclear whether mass layoffs at HHS and CDC this week might stymie such efforts. But steep funding cuts to community health departments announced last week have already forced some areas to cancel vaccine clinics. Dallas County, for example, had to cancel more than 50 clinics. Many had been planned for schools in areas with low vaccination rates. According to an NBC News tally, 628 measles cases have been reported nationally in 2025. Other states with outbreaks include Kansas with 23 cases, Oklahoma with 10 cases, and New Mexico with 54 cases. Public health officials in Ohio have identified 17. The cases at the Lubbock day care center are likely linked to the epicenter of the outbreak, Gaines County, said Lubbock’s public health director Katherine Wells. Wells said she’s been concerned about cases spreading in child care centers since the beginning of the outbreak. “I think we’ll have additional outbreaks in other day care centers,” she said. “This isn’t going to be the only one.” Messick, of the Tiny Tots U Learning Academy, said she and her staff are trying to reduce risk of further spread by watching kids closely for symptoms and isolating certain classrooms. They’re also urging other child care facilities to encourage their families to get the MMR vaccine. Families who choose not to vaccinate their children have been asked to keep them home for at least 21 days. Two doses are almost always enough to give lifetime protection against measles, according to the CDC. Unvaccinated people who are exposed to the virus are almost certain to become infected. The first dose isn’t usually given until after a child’s first birthday, but can be offered early, at 6 months. “That’s the best that child care owners can do right now,” Messick said. “It’s coming. There’s no way around it.” This article first appeared on NBCNews.com. Read more from NBC News here: Trans student’s arrest for violating Florida bathroom law is thought to be a first Former California police officer awarded $10 million in harassment suit USA Fencing disqualifies female fencer for refusing to fight trans opponent ...read more read less