The Texas health department reported 279 measles cases in the state on Tuesday, an increase of 20 cases from its previous count.

Cases in Gaines county, the center of the outbreak, rose to 191 from 174, the Texas Department of State Health Services said.

Hospitalizations rose to 36 from 34 as of March 14, the department said.

The Texas state health department classified 277 patients as “unvaccinated or unknown,” or people with no documented doses of measles vaccine more than 14 days before symptoms appeared.

In New Mexico, cases rose from 33 to 35 on Friday, including two cases in Eddy County and the rest in Lea County, which is adjacent to Gaines County.

The CDC has said that the measles, mumps and rubella (MMR) vaccine is the most important tool for preventing measles.

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