The Texas measles outbreak is up to 124 cases, according to the latest numbers by the Texas Department of State and Health Services. Five of those cases are in vaccinated patients, according to the news release.

It is the worst measles outbreak in the state of Texas in more than 30 years.

As of Tuesday, February 25, DSHS says that 18 patients have been hospitalized since the outbreak began in West Texas in late January. The outbreak has been confirmed in residents of nine Texas counties:

• Gaines County: 80 cases.
• Terry County: 21 cases.
• Dawson County: 7 cases.
• Yoakum County: 5 cases.
• Dallam County: 4 cases.
• Martin County: 3 cases.
• Ector County: 2 cases.
• Lubbock County: 1 case.
• Lynn County: 1 case.

The update also comes the same day that San Antonio’s largest school district issued guidance to parents in the wake of the news that a person who tested positive for the extremely contagious illness traveled to Hays and Bexar County almost two weeks ago.