A measles outbreak in Texas has killed two people, marking the first US measles deaths in nearly a decade, US Health Secretary Robert F. Kennedy Jr. announced Wednesday, according to Kazinform.

One victim was an unvaccinated child who died in a Texas hospital, according to the state’s health department. Kennedy provided no details on the other death.

The Texas Department of State Health Services reported 124 cases since the outbreak began in early January, up from 90 on Friday. Most cases—101—are in people 17 or younger.

Measles was declared “eliminated” in the US in 2000, but outbreaks have returned due to rising anti-vaccine sentiment. The last measles death in the US was in 2015.

The outbreak is centered in northwestern Texas, but cases have also been found in New Mexico, Alaska, California, Georgia, New Jersey, New York City, and Rhode Island, according to the Centers for Disease Control and Prevention (CDC). New Mexico has reported nine cases, including four children.

Kennedy noted this is one of four US measles outbreaks this year, which the CDC defines as three or more related cases. He said his department is closely monitoring the situation.

Measles can cause serious complications, especially for pregnant women and young children, including pneumonia, neurological issues, hearing loss, and even death. Survivors risk developing a degenerative brain disease called subacute sclerosing panencephalitis (SSPE).

Last year, the US reported 285 measles cases, the highest since 2019’s 1,274. In the current outbreak, 18 people have been hospitalized, while Kennedy reported 20 are in quarantine. Five infected people in Texas had been vaccinated.

New Mexico’s congressional delegation urged Kennedy to take action, calling for a vaccination campaign and the rehiring of recently fired federal health workers.

“Just last Friday, two dozen employees at the CDC charged with training public laboratory staffers and supporting outbreak response efforts were fired,” state lawmakers wrote. “Those firings will worsen outbreaks and ultimately threaten the health of all Americans in the face of the next public health emergency.”

The outbreak likely started in a rural Mennonite community with low vaccination rates. Free vaccination clinics are being held in affected areas, including Lubbock, where the child victim died.

Most US children receive two doses of the measles vaccine, which is 97% effective. Texas’ vaccination rate is 94.3%, below the 95% needed for “herd immunity” per the CDC.