North Dakota is the 11th state in the U.S. with a measles outbreak, logging its first cases since 2011.The U.S. Centers for Disease Control and Prevention’s confirmed measles case count is 935, more than triple the amount seen in all of 2024. The three-month outbreak in Texas accounts for the vast majority of cases, with 702 confirmed as of Tuesday. The outbreak has also spread to New Mexico, Oklahoma, and Kansas.Two unvaccinated elementary school-aged children died from measles-related illnesses in the epicenter in West Texas, and an adult in New Mexico who was not vaccinated died of a measles-related illness.Other states with active outbreaks—which the CDC defines as three or more related cases—include Indiana, Michigan, Montana, Ohio, Pennsylvania, and Tennessee.North America has two other ongoing outbreaks. One in Ontario, Canada, has resulted in 1,243 cases from mid-October through April 29. And the Mexican state of Chihuahua had 922 measles cases and one death as of Tuesday, according to data from the state health ministry. Health officials in Mexico and the U.S. say all three outbreaks are of the same measles strain.Measles is caused by a highly contagious virus that’s airborne and spreads easily when an infected person breathes, sneezes or coughs. It is preventable through vaccines, and has been considered eliminated from the U.S. since 2000.As the virus takes hold in U.S. communities with low vaccination rates, health experts fear that spread could stretch on for a year. Here’s what else you need to know about measles in the U.S. How many measles cases are there in Texas and New Mexico? Texas state health officials said Tuesday there were 19 new cases of measles since Friday, bringing the total to 702 across 29 counties—most of them in West Texas. The state also added two hospitalizations to its count Friday, for a total of 91 throughout the outbreak.State health officials estimated about 1% of cases—fewer than 10—are actively infectious.Fifty-seven percent of Texas’ cases are in Gaines County, population 22,892, where the virus started spreading in a close-knit, undervaccinated Mennonite community. The county has had 403 cases since late January—just over 1.7% of the county’s residents.The April 3 death in Texas was an 8-year-old child, according to Health Secretary Robert F. Kennedy Jr. Local health officials in Texas said the child did not have underlying health conditions and died of “what the child’s doctor described as measles pulmonary failure.” A unvaccinated child with no underlying conditions died of measles in Texas in late February—Kennedy said age 6.New Mexico was steady Tuesday with 67 total cases. Seven people have been hospitalized since the outbreak started. Most of the state’s cases are in Lea County. Three are in Eddy County, two in Doña Ana County and one in Chaves County. How many cases are there in Indiana? Indiana confirmed two more cases April 21 in an outbreak that has sickened eight in Allen County in the northeast part of the state—five are unvaccinated minors and three are adults whose vaccination status is unknown.The cases have no known link to other outbreaks, the Allen County Department of Health has said. How many cases are there in Kansas? Kansas added nine cases Wednesday for a total of 46 across eight counties in the southwest part of the state. Gray County is up to 15 cases. The state also reported its first hospitalization.Kansas’ health department didn’t elaborate Wednesday about a discrepancy in the number of new cases at the state and county levels beyond noting that case counts are “fluid as the outbreak progresses.”The state’s first reported case is linked to the Texas outbreak based on genetic testing. How many cases are there in Michigan? Montcalm County, near Grand Rapids in western Michigan, has an outbreak of four cases that state health officials say is tied to the Ontario outbreak. The state had nine confirmed measles cases as of Friday, but the remaining five are not part of the Montcalm County outbreak. How many cases are there in Montana? Montana state health officials announced five cases April 17 in unvaccinated children and adults who had traveled out of state, and later confirmed it was an outbreak. All five are isolating at home in Gallatin County in the southwest part of the state.They were Montana’s first measles cases in 35 years. Health officials didn’t say whether the cases are linked to other outbreaks in North America. How many measles cases are there in North Dakota? North Dakota announced its first measles case since 2011 on Friday, and by Tuesday, there were nine cases.All are in Williams County in western North Dakota on the Montana border. The state health department said Monday that three of the confirmed cases are linked to the first case—an unvaccinated child who health officials believe got it from an out-of-state visitor.The other five cases, announced Tuesday, were people who were not va