The number of cases — Texas’ largest in nearly 30 years — increased by 22 since Tuesday. The Texas Department of State Health Services said cases span over nine counties in Texas, including almost 100 in Gaines County, and 20 patients have been hospitalized.

The child who died Tuesday night in the outbreak is the first U.S. death from the highly contagious but preventable respiratory disease since 2015, the U.S. Centers for Disease Control and Prevention said. The child was treated at Covenant Children’s Hospital in Lubbock, though the facility said the patient didn’t live in Lubbock County.

Robert F. Kennedy Jr., the nation’s top health official and a vaccine critic, said Wednesday that the U.S. Department of the Health and Human Services was watching cases but dismissed the outbreak as “not unusual.”

But on Friday afternoon, Kennedy said in a post on X that his heart went out to families impacted by the outbreak, and he recognized “the serious impact of this outbreak on families, children, and healthcare workers.”

Kennedy went on to say in the post that his agency will continue to fund Texas’ immunization program and that ending the outbreak is a “top priority” for him and his team.

The virus has largely spread through rural, oil rig-dotted West Texas, with cases concentrated in a “close-knit, undervaccinated” Mennonite community, state health department spokesperson Lara Anton has said.

Gaines County has a strong homeschooling and private school community. It is also home to one of the highest rates of school-aged children in Texas who have opted out of at least one required vaccine, with nearly 14% skipping a required dose last school year.

Texas law allows children to get an exemption from school vaccines for reasons of conscience, including religious beliefs. Anton has said the number of unvaccinated kids in Gaines County is likely significantly higher because homeschooled children’s data would not be reported.

The measles, mumps and rubella (MMR) vaccine is safe and highly effective at preventing infection and severe cases. The first shot is recommended for children ages 12 to 15 months, and the second for ages 4 to 6 years. Most kids will recover from measles, but infection can lead to dangerous complications such as pneumonia, blindness, brain swelling and death.

Vaccination rates have declined nationwide since the COVID-19 pandemic, and most states are below the 95% vaccination threshold for kindergartners — the level needed to protect communities against measles outbreaks.

The U.S. had considered measles, a respiratory virus that can survive in the air for up to two hours, eliminated in 2000, which meant there had been a halt in continuous spread of the disease for at least a year. Measles cases rose in 2024, including a Chicago outbreak that sickened more than 60.

Eastern New Mexico has nine cases of measles currently, but the state health department said there is no connection to the outbreak in West Texas.

At a news conference Friday in Austin, officials confirmed the first reported case in Travis County since 2019. Dr. Desmar Walkes of the Austin-Travis County Health Authority said the case involved an unvaccinated infant who was exposed to the virus during a vacation overseas.

Texas Department of State Health Services spokesman Chris Van Deusen said the case was one of four linked to international travel so far this year, none of which were part of the West Texas outbreak. The others were two in Houston last month and one reported this week in Rockwall County, east of Dallas.

In the Travis County case, the child’s family members were vaccinated and were isolating at home and no exposures were expected, Walkes said. She could not give the exact age of the infant.

Officials at the news conference urged people to get vaccinated if they are not already.

“We’re here to say quite simply: Measles can kill, ignorance can kill and vaccine denial definitely kills,” said U.S. Rep. Lloyd Doggett, a Democrat.

School officials in two Texas cities each reported reported one rubella case this week, but Van Deusen said no infections had been confirmed.