Measles have continued to spread in Texas with a total of 561 reported cases. Gaines County, the center of the outbreak, saw an increase of nine cases since mid-April.

The Texas health department reported 561 cases of measles in the state on Tuesday, an increase of 20 from April 11, as the U.S. government said it was sending seven people to the state to help battle the outbreak of the childhood disease.

Measles cases are most likely being underreported in the United States as public health officials scramble to find resources to address a ballooning outbreak in the Southwest, according to a senior scientist at the Centers for Disease Control and Prevention.