The Texas public health department is now reporting a total of 422 measles cases in the ongoing outbreak that began in Gaines County. The outbreak has now spread to two additional counties, both in the center of the state.

Already, the U.S. has more measles cases this year than in all of 2024, the U.S. Centers for Disease Control and Prevention has said. Other states with outbreaks — defined as three or more cases — include New Mexico, Kansas, Ohio and Oklahoma. Since February, two unvaccinated people have died from measles-related causes.

The outbreak has expanded beyond West Texas and the Panhandle with confirmed cases in Erath County, southwest of Fort Worth, and Brown County, between Abilene and Killeen. Lamar County in far northeast Texas has 10 cases. Officials say 42 people have been hospitalized.