Measles had struck this West Texas town, sickening dozens of children, but at the Community Church of Seminole, more than 350 worshippers gathered for a Sunday service. Sitting elbow-to-elbow, they filled the pews,

Texas’ health commissioner told lawmakers Monday they are still trying to determine the origin of a South Plains-Panhandle measles outbreak more than a month after the first patients reported symptoms.

Texas is facing its worst measles outbreak in decades, as cases have jumped from two to 146 in just one month.

Here’s what to know about the outbreak after the first U.S. death since 2015 from the highly contagious—but preventable—respiratory disease.

An unvaccinated child in west Texas died from measles this week, according to a Wednesday news release from the Texas Department of State Health Services. This is the first death from the west Texas measles outbreak that began late last month, and is the first death from measles in the United States since 2015.

Alongside measles in this region, where voters overwhelmingly supported President Donald Trump, there’s another outbreak: one of misinformation about vaccines, distrust of local public health

Measles has sickened nearly 150 mostly unvaccinated people in rural West Texas, and a school-age child has died.

Close-knit religious community claims it has been made a scapegoat for wider issue of anti-vax sentiment in rural West Texas