In what could become a spiraling health crisis for the state, public health officials in Lamar County on Thursday announced four confirmed cases of measles in their jurisdiction. Paris-Lamar County Health District officials said the extremely contagious virus had been diagnosed in four patients who range in age from 5 months to adulthood.

The measles outbreak in the South Plains region of Texas has grown to 223 cases. 29 of those infected have been hospitalized and one school-aged child has died, according to a new update from the Texas Department of State Health Services.

More than 200 cases of measles have been confirmed in West Texas since late January, according to the Texas Department of State Health Services.