The Texas health department reported 422 cases of measles in the state on Tuesday, an increase from 400 on March 28, as the United States battles one of the largest outbreaks of the disease in the past decade.

The measles outbreak in Texas continues to spread, with 422 cases reported since January, an increase of 22 cases since Friday. Most cases are in West Texas, where one child has died. Dallas County Health and Human Services has cut 21 workers,

The outbreak has expanded beyond West Texas and the Panhandle with confirmed cases in Erath County, southwest of Fort Worth, and Brown County, between Abilene and Killeen. Lamar County in far northeast Texas has 10 cases. Officials say 42 people have been hospitalized.

The Texas health department said on Friday that the number of measles cases in the state rose 20% since its last report three days ago, as experts warn they expect the outbreak to further spread in coming weeks.

The number of measles cases in Texas has grown to 422 infections as of Tuesday, including the closest known case to Fort Worth so far.

Kennedy made a show of shipping vitamin A to measles-stricken communities. The state’s public-health department didn’t take up the offer.

The measles outbreak in western Texas is continuing to grow with 327 cases confirmed, according to new data published Tuesday.

"Due to the highly contagious nature of this disease, additional cases are likely to occur in the outbreak area and the surrounding communities," the Texas Department of State Health Services said

Texas has reached 400 cases of measles in an outbreak that started two months ago. Texas, New Mexico, Ohio, Kansas and Oklahoma all have active measles outbreaks.