Outbreaks of measles and whooping cough in Oklahoma have drawn attention to the state's public health data sharing policies. Oklahoma is currently the only U.S. state that limits its public reporting of measles cases to a statewide basis.
Calls for Enhanced Data Transparency
Infectious disease and public health experts emphasize that timely sharing of case data with the public aids communities in mitigating disease spread. Dr. George Monks, a Tulsa dermatologist and former president of the Oklahoma State Medical Association, has made multiple attempts to obtain more granular data from the Oklahoma State Department of Health (OSDH) for several months. His efforts have included social media outreach, open records requests, and complaints to the attorney general's public access counselor, none of which have resulted in the release of the requested county-level data.
Monks states that county-level data is vital for Oklahoma families to make informed health decisions, such as vaccine choices or avoiding high-risk areas. He suggests that withholding this data could impede community responses, particularly given measles' high contagiousness.
Current Outbreak Statistics
As of 2025, Oklahoma has recorded 17 measles cases. Nationally, the United States has experienced the highest number of measles cases in three decades. This year, over 800 of the 2,000 U.S. cases occurred in Texas during the spring, with a current outbreak reported in South Carolina.
Measles is a highly contagious, airborne virus characterized by symptoms including rashes, high fevers, coughs, runny nose, and red, watery eyes. It transmits through airborne droplets from an infected person's coughs or sneezes and can remain viable in a room for up to two hours post-exposure.
OSDH Stance on Data Release
Monks initially requested county-level measles case data and OSDH communications with the federal Centers for Disease Control and Prevention (CDC) in March. While some email correspondence with the CDC was provided, the OSDH declined to release county-level measles data, citing a section of the federal Health Insurance Portability and Accountability Act (HIPAA). The attorney general’s public access counselor, Anthony Sykes, supported the OSDH's position in an October 30 letter, stating the agency had a "good-faith legal basis" for its denial, and noted the OSDH website offers statistical information on measles and potential public exposure.
Researchers at Johns Hopkins University, who developed the U.S. Measles Tracker, reported in September in JAMA that Oklahoma is the sole state not providing measles cases by county or regional level. For comparison, Kansas withholds county-level data only if cases are fewer than five, while Tennessee, Utah, and Iowa provide regional data without county-specific details.
The researchers noted that "single measles cases often represent the leading edge of potential outbreaks," making rapid identification crucial. They emphasized that geographic specificity, even for small case counts, enables targeted public health responses like contact tracing and exposure notifications. They also highlighted that many state health departments routinely report individual measles cases publicly, setting a precedent for disclosure serving public health.
The OSDH stated in an emailed response that its current public data is sufficient for informing local communities about potential measles exposure. This includes overall case counts, vaccination status, age range, median age of cases, and any identified public exposure settings. The department emphasized that "identified exposure locations are what pose a risk of spread to the public, and the county of residence may not always reflect the population or communities that may be at risk during a public health investigation."
The OSDH did not directly address inquiries regarding how other states manage to report county-level measles data. The agency maintains its interpretation of federal HIPAA laws and Oklahoma's public health code, asserting its discretion in determining how communicable disease data is released to ensure compliance with de-identification and disclosure requirements.
Historical Context and Parallels
Oklahoma previously disclosed county-level measles cases during the last significant outbreak in 2019. This current debate over data sharing echoes discussions during the initial year of the COVID-19 pandemic, when Oklahoma faced criticism for its slow release of community-level infection data. During COVID-19, officials initially denied requests for de-identified city and ZIP code data, citing privacy laws, but eventually provided localized data on an online dashboard as the pandemic escalated. The OSDH explained its COVID-19 data reporting was risk-based, necessitating ZIP code-level data for public gathering and school closure recommendations. For measles, the agency argues that exact public setting location and time are sufficient for communicating risk.
Contrastingly, the OSDH's infectious disease website includes the number of cases and county of incidence for West Nile virus. Monks expressed confusion over the OSDH's differing approaches to data release, citing perceived inconsistencies in privacy concerns between measles and West Nile virus data, given that the requested measles data is aggregated and not patient-specific.
The OSDH stated that decisions on releasing county-level data depend on factors such as overall case count, county population, and case investigation impact. For some diseases, like West Nile, geographic location awareness is deemed important for public risk communication. Most diseases publicly reported by the OSDH are stratified by region rather than county to protect patient privacy while still indicating geographic disease burden.
Monks continues to request data for other diseases, including pertussis (whooping cough) and tuberculosis. He noted that Oklahoma is experiencing its worst whooping cough outbreak in 70 years and its worst measles outbreak in 35 years. Monks also suggested that the withholding of detailed respiratory disease data might be a policy decision rather than a public health one, potentially influenced by political sensitivities surrounding vaccine discussions.