The number of people with measles in Texas increased to 146 in an outbreak that led this week to the death of an unvaccinated school-aged child, health officials said Friday. The number of cases — Texas’ largest in nearly 30 years — increased by 22 since Tuesday.

Gaines County in West Texas is at the heart of the ongoing measles outbreak. Non-medical vaccine exemption rates there are high.

Measles was considered to be eliminted in the U.S. in 2000, thanks to vaccine developments. But vaccination rates have dropped since the covid pandemic began.