The number of people with measles in Texas increased to 146 in an outbreak that led this week to the death of an unvaccinated school-aged child, health officials said Friday. The number of cases — Texas’ largest in nearly 30 years — increased by 22 since Tuesday.

The measles outbreak in Texas has reached nearly 150 cases, according to a Friday morning update from the state health department. Health officials said 146 cases have been identified since late January,

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