Delays and gaps in information from health care providers and federal authorities – including medical and transfer records of patients in detention – hindered the city’s ability to trace and contain a measles outbreak tied to immigration detention centers earlier this year, according to emails obtained by El Paso Matters.
All the while, city leaders debated whether to publicly disclose that several cases were linked to a surge of measles at a Sierra Blanca detention facility – ultimately deciding against it because, they said, the detainees fell outside the city’s jurisdiction despite El Paso residents working at the facility.
Those failures came as measles – a highly contagious virus that can spread days before symptoms appear – moved through Immigration and Customs Enforcement facilities in El Paso and Hudspeth counties and into the Borderland community. The transient nature meant patients fell under overlapping jurisdictions and federal agencies.
“Information related to detainee movement and timelines is not routinely shared,” the city’s lead epidemiologist, Vanessa Casner, told El Paso Matters in an email in response to questions about the contents of the emails. “We cannot conduct contact tracing if we do not have accurate, complete information on the cases/contacts.”
The emails obtained through an open records request were exchanged among city health officials and others between Feb. 8 and March 9.
The communications show that a detainee likely bounced through various federal facilities with a measles rash, ambulance crews sometimes transported patients from detention centers to area hospitals without access to medical records, and that some hospital staff appeared unclear on notification procedures about suspected measles cases.
“What it sounds like with the multiple transfers when he had a rash, it’s not being incorporated in their decision-making process that this patient could have a potential communicable infectious disease,” said Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security.
“So, how could it happen?” said Adalja, who reviewed the chain of events in a phone call with El Paso Matters.
The El Paso Department of Public Health reported 24 measles cases this year – the city’s first reported cases since a 2025 outbreak. Of those, eight were in the community and 16 were among detainees at Camp East Montana, the ICE detention facility on Fort Bliss. The last cases were infectious in March, according to the city’s measles dashboard.
All eight community cases are people who work for the federal government or have ties to a federal facility: five West Texas Detention Facility staff, one person associated with the detention center, one U.S. Customs and Border Patrol employee and one U.S. marshal, Casner said.
READ MORE: 17 measles cases reported in El Paso, including 13 at ICE Camp East Montana
The Department of State Health Services reported 136 measles cases this year in Hudspeth County. All of those cases are people in federal custody, with the last case added April 9 to the weekly tally, DSHS spokesperson Chris Van Deusen confirmed.
How it started
The first measles patient identified in El Paso was a 25-year-old man from the Mexican state of Chiapas who arrived in Ciudad Juárez in January. He later shared his journey with city of El Paso epidemiologist Saul Cuevas, whose colleague relayed the investigation in a Feb. 17 email to state epidemiologist Avery Conrad Melendez.
The man stayed in a stash house in Juárez with migrants from South America and Somalia, each waiting for their turn to cross the border into El Paso, according to the email from El Paso epidemiologist Roman Garcia to Conrad. Many of the people in the stash house were sick and dying, the man told Cuevas.
On Feb. 3, the man crossed the border unlawfully and was apprehended by Border Patrol agents who took him to “an unknown facility” before transferring him to the West Texas Detention Facility in neighboring Hudspeth County the next day. ICE oversees the privately run detention center.
By Feb. 6, the man developed a stuffy nose, cough and fever. By Feb. 7, he developed a rash and was transported to the emergency department of Del Sol Medical Center in East El Paso.
The patient was isolated upon arrival, but staff moved him that night to a “regular room and regular floor” where he remained until the next afternoon, according to Garcia’s email. The hospital collected a sample to test for measles, but did not immediately notify the city health department.
Somewhere else on Feb. 7, another man had developed a rash.
Internal emails from Casner state this detainee passed through several holding facilities and was likely detained at Camp East Montana before transferring Feb. 11 to the West Texas Detention Facility. The facility sent the 24-year-old to University Medical Center of El Paso the same day with a rash and fever, according to a Feb. 11 email from Conrad to the city’s epidemiology team.
After the two men tested positive for measles, Casner wrote in a Feb. 18 email to health leadership that information regarding their cases was “extremely limited and incomplete.”
Though the two detainees received treatment in El Paso, they are counted among the Hudspeth County cases.
The city health department went on to administer more than 200 measles vaccines to detainees at Camp East Montana and El Paso County Detention Facility in Downtown, as of April 29. State health services also provided 210 doses to the West Texas Detention Facility, Van Deusen said.
Days pass before health officials confirm measles
When employees at Del Sol Medical Center admitted their patient Feb. 7 for sepsis and suspected measles, they recorded a fever of 100.3 degrees as well as a weak and confused appearance.
But the city health department would not learn of the measles case until two days later, Feb. 9, when Conrad from state health services alerted the city’s epidemiology team. The case was picked up on Texas Syndromic Surveillance, a statewide system that detects early disease patterns based on electronic health records.
In several emails to Conrad, Garcia passed on information he received through phone calls with Minisha Morris, Del Sol’s director of infection prevention and control.
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“She was aware of this patient but did not know if we were still doing the notification, even if just suspected,” Garcia wrote Feb. 17. “I informed her that it should always be the process.”
Morris emphasized “the lack of isolation room availability at that facility,” Garcia wrote Feb. 10.
City epidemiologists confirmed the measles infection Feb. 11 after conducting their own testing. An employee from the health department twice called the intensive care unit at Del Sol Medical Center, but the calls were unsuccessful, Garcia noted. The health department also requested a list of hospital visitors, patients and personnel with possible exposure to measles.
In an emailed statement to El Paso Matters, Del Sol said it follows Centers for Disease Control and Prevention protocols when a patient presents with measles symptoms or when a case is suspected, including placement in a negative pressure or private room and the use of personal protective equipment.
A negative pressure room is an isolation room used by hospitals to prevent the spread of infectious diseases by keeping contaminated air inside.
“These procedures are implemented based on the information we have when patients present to our hospital and throughout the course of care,” the statement said. “Following a suspected case being confirmed, the information is reported to the appropriate local health authorities, and isolation and care measures are implemented during the patient’s treatment.”
Health care providers cannot comment on specific patient cases due to privacy laws.
The hospital discharged the patient Feb. 12 and provided a list of 18 people who had possible exposure to measles, according to an email from Casner to public health leadership.
“It’s clearly suboptimal and not how you would handle a disease like measles,” Adalja said.
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While a fever and rash could present in various conditions, if hospital staff thought there was enough evidence to suspect and test for measles, that should have triggered the threshold to begin containment and communication, he said.
“It doesn’t sound like they followed standard infection control protocol in terms of isolating the patient, and then number two, it doesn’t sound like they notified the appropriate public health authorities in a timely manner that they had a patient that could be measles-positive at that time,” he said. “And as a result, you had multiple exposures occurring in the hospital that would ideally be preventable.”
Dr. Hector Ocaranza, the city and county health authority, said in an email the department recommends placing any patient with a highly contagious disease in isolation within a negative pressure room, but that hospitals follow their own infection control protocols.
Tracing exposure from detention facilities into El Paso community
The city confirmed a second measles patient Feb. 11 at UMC. The public hospital implemented airborne precautions upon arrival and placed the patient in a negative pressure room, according to health department emails.
Records showed the health department received disjointed information about the patient’s whereabouts prior to his Feb. 11 arrival at the West Texas Detention Facility, which holds people under custody of the U.S. Marshals Service.
According to CBP Commander Dakota McMurray, chief of the agency’s health security division, the patient was detained and initially taken to Fort Hancock holding area, moved to Border Patrol holding center on Gateway South Boulevard in El Paso and then subsequently transferred to custody of the Marshals Service for transport to the West Texas Detention Facility, Casner wrote in a Feb. 13 email to health leadership.
Emails indicate the patient was at an El Paso ICE detention center, but it’s not certain precisely which days. Loyal Source, the medical subcontractor at the ICE camp and the West Texas Detention Facility, provided limited information at the time.
Dr. James Wilson, the medical director of Loyal Source, did not respond to El Paso Matters’ requests for comment.
The Marshals Service said the detainee was in court, possibly with dozens of people, and at the El Paso County Detention Center, “but did not provide any information on the location of the court, the times of the court hearings, or any employees who may have been exposed,” Casner wrote.
By Feb. 19, the health department confirmed its first measles case at Camp East Montana and additional cases at the West Texas Detention Facility. The Camp East Montana detainee was in CBP custody prior to his transfer and was a close contact of one of the initial patients, according to a Feb. 22 email from Anita Wade, CBP public health analyst. Wade did not say in the email where the patient was held while in CBP custody.
The Marshals Service, DHS, ICE and CBP did not respond to requests for comment.
Phone calls from El Paso Matters to the West Texas Detention Facility went unanswered.
Brandon Rohrig, deputy health director, told Ocaranza and Casner in a Feb. 22 email that he didn’t believe ICE was being transparent with how many people were in their detention facilities. As measles cases mounted, one colleague asked if the health department could include data on vaccination status.
“We unfortunately are not able to get the detainee vaccination status,” Rohrig responded in a March 2 email. “ICE and the facilities hardly know who is in and out of their buildings, they don’t share the names of some people with us, and they don’t allow us to speak with the detainees.”
Camp East Montana went into quarantine for two periods in March. By then, measles had spread into the community through federal workers, including employees at the West Texas Detention Facility who live in El Paso County.
Amesh from the John Hopkins Center for Health Security said local health departments need as much information as possible to manage and extinguish an outbreak, such as dates of contagiousness and vaccination status of people the infected person might have exposed.
“If you don’t have this type of information, then what ends up happening is the local health department lacks situational awareness,” he said. “So, they’re unable to do the job they’re constituted to do because they’re basically flying blind when it comes to the critical data they need to keep the public as safe as possible.”
A breakdown in communication also seemed to occur sometimes between the detention facilities and hospitals.
In an early March email conversation with Ocaranza, Rohrig said El Paso hospitals requested a form the health department could provide detention facilities to send with incoming patients suspected to have measles.
“It seems the detainees are being transported via ambulance from the ICE and CBP facilities and neither the facility or the EMT crew are notifying the hospital about the patients’ status upon arrival,” Rohrig wrote March 6.
“From our understanding, some of the EMTs may have a form, but most do not,” he wrote. “The current process is just to pick up the detainee and bring them to the hospital for a checkup and testing.”
Gustavo Tavarez, El Paso assistant fire chief, told El Paso Matters in an email that emergency medical services crews report potential or known contagious diseases to the receiving facility, but “EMS crews are not always provided a patient sheet or complete medical information during an emergency incident.”
The El Paso Fire Department transports patients via ambulance from Camp East Montana and the El Paso County Detention Facility when emergency medical response is required. Non-emergency patient transports are typically handled by other ambulance services, Tavarez said. The city does not respond to emergency incidents at the West Texas Detention Facility.
Ocaranza said in an email that while the health department can provide recommendations, it’s up to each facility, organization or company to develop and implement its own infection prevention and control protocols.
City leaders withhold connection to Sierra Blanca detention center
As the health department discussed the measles cases internally, leaders disagreed with how to communicate the outbreak to the public.
On Feb. 25, the day before the city sent its first news release about community measles cases, health director Dr. Veerinder Taneja asked city government spokesperson Laura Cruz-Acosta, “are we not mentioning anything about the detention center cases?”
“The direction I was given is only to advise on the 4 El Paso community residents,” Cruz-Acosta responded in an email that same day. It’s unclear who, if anyone, gave the directive. “The detainees are not under our jurisdiction, the authorities of those facilities would need to advise the public.”
Later that night, Taneja wrote, “Also, the media always asks about sources, if these are travel related or not or tied to a know(n) outbreak. So we will have to advise that it is tied to an institutional outbreak.”
“We would need to get direction from the leadership,” Cruz-Acosta responded. “I’m not comfortable deciding this without proper discussion.”
El Paso Matters asked Cruz-Acosta on Feb. 26, in response to the initial news release about measles cases in El Paso, whether the community measles cases involved people who worked at Camp East Montana, which was the only facility mentioned in the release.
Cruz-Acosta responded that the community cases weren’t connected to Camp East Montana, but didn’t mention the connection to the detention facility in Hudspeth County.
El Paso City Manager Dionne Mack told El Paso Matters in an email there was no directive to withhold information and that the city publicly reported cases with ties to Sierra Blanca in February.
The city’s Feb. 26 news release mentions measles cases at Camp East Montana, but does not disclose surging cases reported at the West Texas Detention Facility nor does it tie the community’s cases to the detention facility. The city’s March 5 news release announcing new cases in the community and in local detention facilities also does not mention the Sierra Blanca facility.
The Texas Tribune broke the news March 26 that El Paso’s first community cases were employees at the West Texas Detention Facility.
“The West Texas Detention Facility is located in Hudspeth County, not El Paso County, while the East Montana facility is within El Paso County,” Mack said in an email to El Paso Matters. “Communication reflected that jurisdictional distinction.”
“This approach helps ensure the public receives accurate information, avoids confusion between jurisdictions, and supports a coordinated public health response,” Mack said. “Facility-specific information outside El Paso County should come from the appropriate jurisdictional authorities.”
SEE ALSO: Two cases of tuberculosis detected at Camp East Montana El Paso ICE facility
U.S. Rep. Veronica Escobar of El Paso said it would have been better to err on the side of transparency. Escobar said when she first heard of the measles cases, she felt like she had to do detective work to learn what was going on because of limited updates from ICE. The congresswoman said she has little faith in the safeguards in place at Camp East Montana.
Escobar last visited the ICE detention facility April 6, after the facility reopened from quarantine. In all her visits she has never seen personnel wear PPE such as masks to prevent spread – even when walking into pods with detainees who have not been tested for tuberculosis, Escobar said.
“It’s not just a concern I have about the detainees, but also the movement that happens between communities and between facilities and the fact that there is exposure to the El Pasoans who work inside of those facilities,” Escobar said.
The post How measles reporting gaps by ICE, hospital delayed El Paso’s response to outbreak appeared first on El Paso Matters.
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