Paul Monies, Oklahoma Watch

Outbreaks of measles and whooping cough in Oklahoma have led to calls for greater transparency from the Oklahoma State Department of Health as the state stands alone in only sharing measles cases on a statewide basis.

Infectious disease and public health experts said the timely sharing of cases with the public can help communities mitigate the spread of disease.

Dr. George Monks, a Tulsa dermatologist and former president of the Oklahoma State Medical Association, has been trying for months to get the state Health Department to share more data. He’s employed social media cajoling, open records requests and complaints to the attorney general’s public access counselor, to no avail.

“This data is crucial for Oklahoma families to make informed decisions about their health, whether it be vaccine choice or avoiding high-risk areas,” Monks said. “Withholding that county-level measles data could delay the community response, especially since it is so contagious.”

To date, Oklahoma has recorded 17 cases of measles in 2025. Nationally, the United States has had the highest number of measles cases in three decades. More than 800 of the 2,000 U.S. cases this year came in Texas back in the spring, although South Carolina is dealing with a current outbreak.

Measles is a highly contagious, airborne virus with symptoms including rashes, high fevers, coughs, runny nose and red, watery eyes. The virus spreads through the air when an infected person coughs or sneezes. It can linger for up to two hours in a room after exposure.

Monks first requested measles case data by county in March, along with agency communications with the federal Centers for Disease Control and Prevention about a measles outbreak in Oklahoma. The state Health Department provided some email correspondence with CDC, but it cited a section of the federal Health Insurance Portability and Accountability Act, or HIPAA, in declining to release county measles data. Monks shared his requests and responses with Oklahoma Watch.

In its Oct. 30 letter siding with the state Health Department, the attorney general’s office said the agency’s response was reasonable and noted its website has statistical information related to measles and potential public exposure.

“Based on the information available to me at this time, I conclude that OSDH has a good-faith legal basis to deny access to the records sought by Dr. Monks,” wrote Anthony Sykes, the attorney general's public access counselor.

Oklahoma is the only state not providing measles cases by county or on a regional level, according to researchers at Johns Hopkins University. They published a study in September in JAMA, the journal of the American Medical Association, detailing their efforts to develop the U.S. Measles Tracker.

Kansas only withholds county-level measles data if the cases are fewer than five, the researchers noted. Tennessee, Utah and Iowa provide regional case data, but not by county.

“Single measles cases often represent the leading edge of potential outbreaks, making their rapid identification crucial for public health response,” the researchers said in a supplemental paper describing their methodology. “Geographic specificity, even for small case counts, enables public health officials to implement targeted contact tracing and exposure notifications.

“Many state health departments routinely report individual measles cases in public communications, press releases, and exposure notifications, establishing precedent that individual case disclosure serves legitimate public health purposes.”

Oklahoma used to disclose county-level measles cases as recently as 2019, during the last major measles outbreak. Media reports from that outbreak show measles in Okmulgee County.

In an emailed response to questions from Oklahoma Watch, the state Health Department said its public data is sufficient to inform local communities of potential exposure to measles.

It provides overall case counts, vaccination status, age range, median age of cases and any public exposure settings identified through investigation of a measles case.

“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 agency said.

The state Health Department didn’t directly address questions on how other states are able to report county measles data. The agency said it continues to rely on its interpretation of federal HIPAA laws and Oklahoma’s public health code in not releasing county-level measles data.

“Accordingly, OSDH has the discretion to determine the manner in which statistical communicable disease data may be released to the public to the extent that such release is in compliance with de-identification and disclosure requirements of HIPAA,” the department said in the email.

Echoes of COVID

The debate over how and when to share infection data echoes those in the first year of the COVID-19 pandemic. Oklahoma was slow to share community-level infection data. Even then, it provided county-level case information.

In those first few months of the pandemic, Oklahoma Watch requested de-identified COVID-19 data from the state Health Department, including by city and ZIP code. Officials initially denied the request based on federal and state privacy laws, although those laws include exemptions to allow de-identified data. As the pandemic escalated, state health officials eventually provided localized data for COVID infections on an online data dashboard.

The state Health Department said it used a risk-based approach to reporting COVID-19 cases to make recommendations around public gatherings and school closures.

“The only way to implement such a system was to report ZIP code-level data,” the department said. “For measles, using exact public setting location and time provides individuals the information necessary to communicate the risk to the public. Again, it’s all about risk and managing it in such a way as to balance the public’s need to know with our obligation to protect an individual’s health information.”

The state Health Department sent out potential measles exposure alerts earlier this year. The alerts included the addresses of stores and restaurants an infected person had visited.

Oklahoma public health officials withholding of county-level measles data contrasts with the state’s tracking for West Nile virus, a mosquito-borne disease. The state Health Department’s infectious disease website includes the number of cases and county of incidence for that virus.

“I don’t get it,” Monks said. “They’re citing these privacy concerns (for measles), but there’s no patient data assigned to this. It’s all just aggregate data. I don’t get how they can come down on one side and then a different side based on the infectious disease.”

The state Health Department said decisions about releasing county-level data are made based on a number of factors, including overall case count, population of the county and case investigation impact.

“For some diseases, like West Nile, it is important that the public is aware of the geographic location of the case to communicate the risk of disease to the public,” the agency said. “The majority of diseases publicly reported on our website are stratified by their respective region, rather than county-level, to help protect patient privacy, while still providing the public with a geographic distribution of disease burden.”

Monks continues to request disease data from the Health Department. He’s asked for more information about pertussis, commonly called whooping cough, and tuberculosis.

“This is a really important time to get this data out to the public,” Monks said. “In Oklahoma, this is the worst whooping cough outbreak in 70 years and the worst measles outbreak we’ve had in 35 years.”

Monks said it's a policy decision, not necessarily a public health decision, to withhold detailed data about respiratory disease outbreaks. Monks, who describes himself as a Reagan Republican, suspects some state leaders don’t want to raise the ire of the federal Health and Human Services Department under the leadership of Robert F. Kennedy Jr., a longtime vaccine skeptic.

“From the Republican standpoint, some have taken this position that this is a political football, and they really want to get away from pro-vaccinations and pro-science, especially in a primary,” Monks said.

This article first appeared on Oklahoma Watch and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

This article originally appeared in Oklahoma Watch, a nonprofit news organization that produces in-depth and investigative journalism as a public service.

The state Election Board dismissed the Republican member and a Republican alternate from the Oklahoma County Election Board after it determined they failed to certify election results, refused to approve meeting minutes and didn’t disclose conflicts of interest.

In a special meeting, the state board voted Wednesday to dismiss Oklahoma County Election Board Vice Chair Cheryl Williams and Republican Alternate Jenni White after a daylong executive session behind closed doors at the Capitol.

The state board also voted to refer the matters to Oklahoma County District Attorney Vicki Behanna and Attorney General Gentner Drummond for further investigation. It directed the Oklahoma County Republican Central Committee to recommend GOP replacements to the county election board by Feb. 7.

The motion removing White accused her of “purposefully and/or recklessly disseminating false information about Oklahoma’s election system and procedures.” It also said she failed to remove false information. White wrote a Jan. 7 blog post discussing her complaints about the electoral process on the website of Reclaim Oklahoma Parent Empowerment. She also hosted a Jan. 24 ROPE podcast on YouTubediscussing election security. It contained an error that she later corrected, White said.

Republican Party activists packed the meeting room on Wednesday before the state election board went into executive session to hear from Williams, White and other election officials, including Oklahoma County Election Board Secretary Doug Sanderson.

At one point, Rep. Jim Olsen, R-Roland, attended the executive session. Olsen is chairman of the House Election and Ethics committee and can attend executive sessions of agencies and boards under his committee’s oversight.

County-level election secretaries are appointed by the state election board, which has the power to remove party representatives from those county election boards. The Republican and Democratic parties in each county recommend a member and an alternate to serve on the three-member county election board.

In an interview Thursday, White said she wasn’t expecting to be dismissed from the alternate position. White said she outlined her questions and complaints in a letter to state election board officials. She received a three-page reply, but then was told to appear before the state board.

“My complaints were mainly about procedure, not personnel, and then suddenly it became all about personnel, not procedure,” White said.

“How was I derelict in my duties?” White said. “I literally went to complain because I wasn’t allowed to do the duties I was trained to do. Because in the training manual, it says where to count the absentee ballots. So how could I be derelict in my duty if I literally complained to them about not being able to do my job?”

Before she appeared before the board in executive session, Williams said she was summoned to the state board for asking questions about election procedures at the Oklahoma County Election Board following a Dec. 12 special election in Oklahoma County.

Williams said a closed-circuit television system for the Republican and Democratic board members to watch absentee ballots being processed didn’t comply with the handbook or training she received for the position. She said Oklahoma County also didn’t have permission to process absentee ballots a day before the Dec. 12 special election.

In a Dec. 12 letter to Sanderson, State Election Board Secretary Paul Ziriax said an Oct. 25 request from Sanderson to meet and process absentee ballots contained a typo referring to the dates. Ziriax amended his authorization to cover the processing of absentee ballots from Nov. 27 to Dec. 11.

“It is unfortunate this occurred,” Ziriax said in the letter. “Had those dates been included in your original request, I would have also approved those dates.”

Williams, who took over from longtime GOP county election board member Anita DeToy in May, said she wasn’t questioning Oklahoma’s entire election system. Williams said she wanted to verify absentee ballots in person and not via CCTV in the next room. She said discussions with GOP counterparts at other county election boards led her to believe Oklahoma County was alone in using CCTV for that part of the election process.

“Our elections are some of the best in the nation,” Williams said. “I do believe that. Those (voting) machines have been in place for at least 20 years.”

David Glover, the Democratic chairman of the Oklahoma County Election Board, said the county has been using the CCTV system during ballot processing without incident or complaints for several years. Glover was among the witnesses called before the board in the executive session.

A spokeswoman for the state Election Board said Ziriax could not comment on the dismissals because they were personnel matters.