The Texas health department reported 422 cases of measles in the state on Tuesday, an increase from 400 on March 28, as the United States battles one of the largest outbreaks of the disease in the past decade.

The Texas measles outbreak has expanded to 422 cases across multiple counties, 44 hosiptlized for the start of April with health officials urging vaccination.

The Texas Department of State Health Services reported 22 new measles cases in connection with a West Texas measles outbreak Tuesday. The agency reported cases in two Central Texas counties that hadn't previously reported cases, Brown and Erath counties. Tuesday's update brings the total number of cases since January to 422.