The measles outbreak in Texas has reached nearly 150 cases, according to a Friday morning update from the state health department. The agency said 146 cases have been identified since late January. Twenty of those patients have been hospitalized, and one school-age, unvaccinated child has died.

The latest update comes two days after the first death was reported in a school-aged child who lived in the outbreak area.

An unvaccinated child has died from measles in West Texas, officials said, marking the first fatality from the disease in the U.S. since 2015. The Texas Department of State Health Services (DSHS) confirmed the death on Wednesday but did not disclose the patient's age.