Two dozen cases of measles have been reported in a small West Texas county that has one of the state’s highest vaccine exemption rates. In Gaines County, which has a population of about 22,000, 24 cases of the airborne infectious disease have been reported since late January. Most of them are unvaccinated, school-aged children.

The Texas Department of State Health Services has identified 24 measles cases in connection with the onset of symptoms within the last two weeks. Gaines County, a small county in West Texas, has one of the highest rates of vaccine exemptions in the state.

A measles outbreak is growing in a rural area of West Texas where vaccination rates are well below the recommended level.