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.

As the measles outbreak in West Texas continues to grow, North Texas doctors say they’re fielding a growing number of questions from concerned parents. Dr. Christopher Dreiling, a pediatrician at Pediatric Associates of Dallas, said his office has had “dozens and dozens” of measles inquiries.

Vaccine hesitancy has been rising for years in the United States. Doctors and parents in one rural county are confronting the consequences.