Declining vaccination rates, decreasing trust in government and a political unwillingness to endorse vaccines is shaping Texas’ measles response.

The first death in relation to the ongoing measles outbreak in West Texas has been confirmed by local and state health officials. The patient was an unvaccinated school-aged child, hospitalized in Lubbock last week.

The Texas Department of Health and Human Services releases updated numbers of cases every Tuesday and Friday.

The largest measles outbreak in decades has reached San Antonio and San Marcos. Officials say an individual who tested positive for the virus in West Texas traveled to two major universities and one of the nation's busiest tourist attractions — the San Antonio River Walk.