North America has two other ongoing outbreaks, all of which are the same measles strain. One outbreak in Ontario, Canada, has resulted in 1,440 cases from mid-October through May 6, up 197 cases in a week. And the Mexican state of Chihuahua had 1,041 measles cases and one death as of Friday, according to data from the state health ministry.

Katherine Wells, the public health director in Lubbock, Texas, describes her fight to stop the largest measles outbreak since 2000, despite a chaotic reorganization of federal health agencies.

Texas’ measles outbreak that began in Gaines County in January has now expanded to 709 cases, officials said on Friday. The update from the Texas Department of State Health Services does not include additional cases,