The measles outbreak in West Texas has escalated to 48 confirmed cases, the highest in nearly 30 years, largely affecting unvaccinated children and teens. Thirteen individuals have been hospitalized. The outbreak, concentrated in rural Gaines County, is connected to private religious schools and a hesitant Mennonite community. Health officials are ramping up vaccination outreach and screening to combat further spread. A worrying development includes a confirmed case in Lea County, New Mexico, raising alarm about cross-border transmission. Additionally, the percentage of school-aged children opting out of vaccines has increased, complicating public health efforts.