Ave Maria, Florida—One Wednesday this month, loud cries erupted from two teenage girls gathered around a cellphone in a supermarket parking lot. They had just discovered that a classmate from a nearby K-12 school had been diagnosed with measles. As a result, unvaccinated students would be barred from attending school for the next month.
I overheard the noise while packing my notebook, readying to leave Ave Maria, a small and rapidly expanding community located near the northwestern edge of the Florida Everglades. Its formal leadership is quite minimal, primarily consisting of local real estate developers and the heads of the Catholic Church that form the basis of the community.
My visit was prompted by one of the largest measles outbreaks on a college campus in decades, which had erupted just a few blocks away at Ave Maria University at the end of January. Strangely, little information was being disseminated to the public about it.
For a month, I attempted to reach the Florida Department of Health and Ave Maria University via phone and email, but to no avail. So, I decided to travel to the heart of the outbreak area. Over 100 measles cases have now been reported in the county, with 88 confirmed and 16 classified as probable.
My visit shed light on the numerous developments occurring outside public view, yet that evening at the grocery store, I felt disheartened. I was still unable to determine the outbreak’s trajectory or assess the community’s risk level.
Just a couple of hours prior, I had been admonished by the university president for attending a town hall meeting for students. He refused to answer any of my questions regarding the outbreak. During my visits to county health offices, I had only received new phone numbers to call, but no calls back. Locals also seemed somewhat indifferent to my inquiries about measles, often reminiscing in the past tense as if the outbreak was over.
Many in the community seemed to believe the outbreak had subsided and that they were safe. Yes, there had been a measles outbreak, but it had stayed “across the street,” as locals put it, referring to a small road marking the unofficial boundary between the university’s campus and the town.
However, for a small group of plugged-in individuals—local healthcare providers and a former assistant secretary from the U.S. Department of Health and Human Services—this moment in the supermarket parking lot was anticipated: Measles had spread from the university to the wider community, indicating that a second wave of the outbreak might be on the way.
Measles is incredibly contagious. Florida’s outbreak has not reached the catastrophic levels seen in previous years, such as those in Texas and South Carolina, but it is still noteworthy; before last year, there had only been ten instances in the past 25 years where an outbreak exceeded 50 cases. While vaccines can effectively prevent it, any area experiencing a vaccination rate below about 95% is at risk.
Ave Maria is situated in Collier County, which has reported at least 104 measles cases since January, with over 10% occurring in just the last two weeks since the virus spread “across the street.” Most cases in the county have arisen among the 15-to-24 age group, aligning with the outbreak on the university campus, but not all cases are college students; a growing number involve young children and teens.
I managed to connect with a few community leaders who had positive remarks regarding the local health department’s response to the measles outbreak. However, the department hasn’t replied to any of my inquiries over the past month, so I still lack firsthand knowledge of what actions have been taken or are still ongoing.
Experts in public health and infectious diseases indicate that the noticeable lack of public communication has likely impeded the response to the outbreak. There was definitely more that could have been done to curb the spread and prevent additional cases.
“Most jurisdictions strive to inform the public about measles outbreaks because they require public involvement to control the situation,” stated Dr. Caitlin Rivers, an epidemiologist and director at the Center for Outbreak Response Innovation at Johns Hopkins.
“Given that measles is airborne and highly transmissible, there are instances where public exposure in places like grocery stores or medical clinics require greater attention,” she added.
Ave Maria promotes itself as a “big kind of small town,” and indeed it’s expanding quickly. Thousands of new homes are emerging in this rural Collier County area, situated between Naples and Fort Lauderdale. Around 8,000 people currently reside in Ave Maria, with roughly 1,300 students enrolled at the university.
I traveled into town along what is known as Alligator Alley, and after a few miles of rural roads marked with panther crossing signs, palm trees appeared, leading me to the town center. A massive Catholic church stands prominently in the main square, surrounded by shops and restaurants, directly across from Ave Maria University’s campus.
While standing in the town center, I noticed a particularly bright spot on the pavement: a Domino’s Pizza logo was inscribed on one of the stones. Interestingly enough, the pizza chain’s former CEO founded Ave Maria University and played a role in the town’s development.
In the town center, people on golf carts, bikes, and scooters seemed to outnumber those in cars. Most wore typical Florida attire, like casual sundresses and polo shirts. I spotted one golf cart driver—dressed in a sharp navy suit with a colorful pocket square—an indication of life in a small town.
I walked a few blocks for a meeting with Tony Musingo, a local physician assistant who had diagnosed many of the first measles cases in the area. He preferred not to meet in his office; the clinic had moved its check-in outside due to the measles outbreak and was generally careful about who could enter.
A graduate student studying theology at the university—also among the early measles cases—helped arrange my meeting with Musingo and guided us to a shaded patio for our discussion. The well-dressed man I had noticed in the golf cart awaited our arrival: Michael Caputo, a former assistant secretary for public affairs in the first Trump administration during the initial year of the Covid-19 pandemic.
Caputo now runs a startup biotech firm in Ave Maria and studies theology at the university. His company has developed a device that functions like a smoke detector for airborne viruses, and the university is currently using pilot models in some classrooms.
As measles cases rise across the country, states facing outbreaks have been diligent in providing updates and ensuring their leaders are accessible for questions. South Carolina’s health department began hosting weekly media briefings when their outbreak had fewer than a dozen cases, while Utah health officials have also conducted multiple briefings on their situation.
Despite Florida currently ranking third in measles cases, the state’s communication seems lacking. It offers a case count per county and filters by age, but with minimal context, simply updating once a week.
Data reveals that the outbreak in Florida has extended beyond the college campus, according to Rivers, the epidemiologist whose organization developed a measles case tracker. She emphasized that outbreak information is generally pertinent to the entire community.
Initial updates on the outbreak from Ave Maria University were regular and often included more recent case counts than the state health department. However, over time, those updates became less frequent, and the university began linking back to the state’s data, effectively revising its count down from earlier reports.
The university’s website includes a contact for media inquiries, yet that individual did not respond to my questions concerning the outbreak. Instead, during my visit, she sent an email reiterating the president’s statement that I wasn’t welcome on campus and did not return my follow-up call.
It seems that the public health response to the measles outbreak in Ave Maria is as elusive as the Florida panther—recognizable but not easily seen by the public. One must know where to look.
The absence of clear communication from the health department has left that role to other town leaders, all seemingly coordinated by Caputo.
When I found myself unable to reach the state health department or the university, I sought information through alternative channels: local churches, builders’ associations, community organizations, and more.
Most did not respond, but they informed Caputo of my inquiries. This is a small town; he knew I was there and was aware of whom I wanted to speak with.
While he might not have signed up for it, Caputo seems to have embraced this role. He has coordinated with the local parish on a messaging plan about measles that has been communicated during multiple masses and even contributed to the email sent by the K-12 school once a student tested positive.
Not too long ago, his company—Ave Maria Biotech—sent out email blasts informing residents about a webinar featuring local healthcare providers and Dr. Robert Redfield, the CDC director during the first Trump administration.
Redfield raised alarms about a potential second wave and stressed the risks that measles poses, particularly to pregnant women. He also encouraged vaccinations, advocating for the measles-mumps-rubella (MMR) vaccine. Interestingly, the Catholic Church has dispelled concerns regarding fetal tissue use in vaccine development, presenting vaccination as morally acceptable—and virtuous.
When I asked Caputo how he perceives his role in the response to the measles outbreak, he stated he’s simply a concerned resident.
“No one wants a self-appointed expert to come in and dictate what they should do, so I’ve tried to remain in the background,” he expressed. “I think the community has handled things really well.”
Both Caputo and Musingo acknowledge that when the first outbreak cases were reported, they expected a far worse scenario than what unfolded.
Congregation plays a vital role in Ave Maria, they remarked. Strong community ties facilitate daily church services, neighborhood rosary walks, university classes, and various local events. They feared there were too many instances for the virus to spread.
“The students really stepped up,” said Caputo, who observed that they would isolate when feeling unwell and mostly remain on campus. “People here genuinely look out for one another.”
Still, Caputo notes he would have liked more updates from the state health department.
“This is a storytelling town, and they’re missing the narrative,” he remarked.
In many respects, it appears that state leadership is particularly inclined to downplay the story. But past experiences have shown that effective public communication is essential for families and healthcare providers to manage a measles outbreak.
It’s crucial for families to hear directly from the health department during an outbreak since they are the experts, noted Dr. Jennifer Takagishi, vice president of the Florida chapter of the American Academy of Pediatrics. The department plays a critical role in data gathering and orchestrating the response.
“For families who might have limited access to healthcare, the health department serves as a safety net,” she added. “There is increasing hesitancy and mistrust toward science and medicine, so equipping doctors with meaningful and timely data to explain is critical.”
Local healthcare providers harbor suspicions that while the health department managed to facilitate a vaccination clinic, it may not have adequately publicized the importance of the vaccine or its availability—potentially resulting in a less effective outcome. I would have liked to address this with the state health department had I managed to reach them.
What I do know is that Florida Surgeon General Dr. Joseph Ladapo has recently spoken in favor of the “medical freedom” movement. He aims to ban mRNA vaccines in the state and has declared plans to end childhood vaccination mandates, equating them to slavery.
“I’ve noticed some state officials are hesitant about vaccinations themselves, hence they’re not advocating for them among our families,” said Takagishi, who practices a few hours north of Ave Maria in Tampa. “What we would prefer is for them to proactively engage with the public and encourage families to get vaccinated so we can either prevent outbreaks or manage them quickly before they escalate.”
The absence of an official message has left many locals with a false sense of security, thinking the outbreak is over even as cases continue to add up.
Common sentiments during my early visits included that the situation was “over.” Yet, some hesitance crept in, leading to follow-up questions: “Isn’t it?”
Recently, Ave Maria University has removed its “campus health update” link from the homepage. The last update, posted a couple of weeks ago, stated that “there are currently zero nurse-assessed confirmed cases on campus,” but it also shows a total case count that falls nearly a dozen cases short of the current county total.
The announcement of a measles case in the K-12 school seemed to shift public sentiment, bringing to light some fears. It was only when reports emerged of cases among younger students that I detected mentions of apprehension.
Jessica Tolentino doesn’t reside in Ave Maria, but visits often, as her husband oversees some new developments, and her teenage son has friends at the private school.
Earlier that week, her son had mentioned that some friends were gathering to play basketball, but he didn’t want to participate because “something was going around.” This was uncharacteristic of him, making her particularly alert when the measles news broke.
“If the case was just confirmed Wednesday, it means the spread likely began before that,” Tolentino noted.
She’s especially concerned because her younger son has a heart condition that makes him more vulnerable to severe complications from viruses. He had to skip certain vaccines during his early years but is vaccinated against measles now. Still, his compromised immune system brings greater risk.
“We might have to steer clear of town for a while,” she said.
Caputo and Musingo remain optimistic, believing that all signs suggest the second wave will be minor. Yet, after spending time in town and checking with the nearest health department, I still can’t discern what the formal public health response will entail.
The Diocese of Venice, which governs the local Catholic Church, claims it has collaborated with the Florida health department to develop quarantine protocols for students. They’ve also canceled certain events for parents amid the outbreak.
The diocese has noted that a local pediatrician is providing MMR vaccinations through extended office hours and home visits. However, it hasn’t clarified whether the Florida health department will actively assist with promoting vaccinations or ground-level outbreak management.
I encountered one dad taking two of his five kids to the pediatrician for a checkup. He quickly insisted that it was unrelated to measles, as they had just moved to town over the summer and some children were now ready for school.
Keeping unvaccinated children out of school is a “hard decision,” he shared. “But it’s a safe and necessary measure that should help bring things under control.”
Hearing about the measles case at the school made him “a bit anxious,” he admitted, “but we’re vaccinated.”
Only time will reveal how the measles outbreak unfolds in Ave Maria, but I plan to keep an eye on the weekly case counts and continue seeking more information from the Florida health department.
