A dangerous measles outbreak that started in western Texas in January has now grown to nearly 330 cases in the state, according to new data from the public health department.

On Tuesday, the Texas Department of State Health Services reported that there have now been 327 cases of measles since the start of the year, with 40 patients who have had to be hospitalized.

Measles is caused by a highly contagious virus that can be spread through breathing, sneezing or coughing. And while it’s easily preventable through vaccines, public health data shows that, of the 327 current cases in Texas, 325 of the infected individuals were either unvaccinated or their vaccination status is unknown.

This year already represents the most measles cases Texas has had since 1992, when the state reported more than 1,000 measles cases over the full year.

The majority of infections have been in children, and an unvaccinated child died last month in Texas from the outbreak.

Health and Human Services Secretary Robert F. Kennedy Jr. has spread misleading claims about vaccinations, and initially downplayed the current spread of measles.

“It’s not unusual,” he said in February when asked about the death of the Texas child. “We have measles outbreaks every year.”

The outbreak has also spread to other states, including New Mexico and Oklahoma. On Tuesday, New Mexico reported 43 total cases. Oklahoma has reported nine cases so far.