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Cases of the incredibly contagious measles virus are continuing to rise in Texas and across the US as the nation's top health official promotes treatments not supported by health experts.
To date this year, the US has recorded more than 250 measles cases across several states, including Oklahoma, Alaska, California, Georgia, Florida, New York, Kentucky and Rhode Island.
The epicentre remains in western Texas and neighbouring New Mexico, where two unvaccinated people have died from the virus.
It comes as Health Secretary Robert F Kennedy, Jr continues to focus on unproven treatments like cod liver oil, and his casting doubt on the safety of the vaccines.
The BBC has contacted the Department of Health and Human Services (HHS) for comment.
Measles is a dangerous virus that has no cure and can lead to a host of complications, including pneumonia and brain swelling. It can be deadly.
Vaccination rates must be 95% or higher for the broader population to be protected, but several communities where the virus is spreading have rates well below that.
The US declared measles eliminated in 2000, but outbreaks have continued to crop up in recent years as anti-vaccine sentiments have grown.
Health officials say cases have shown no signs of slowing down in western Texas, where two pregnant women recently reported infections.
Across the state's border, New Mexico now has more than 30 cases, while new infections have been confirmed in Oklahoma, New York and in Los Angeles this week.
In several instances, unvaccinated Americans have spread measles to others after contracting the virus outside of the country, including on Long Island in New York, where a baby caught the virus while traveling with family, health officials say.
Cases are also on the rise in Canada, which has reported 146 infections.
Kennedy has so far offered mixed messages about the outbreaks.
At first, he suggested the rising cases were "not unusual" for the US, before backtracking and calling the situation "serious".
Then, this week, in an interview with Fox News, Kennedy suggested cod liver oil and other alternative measles treatments had proven "miraculous".
The remarks are resonating with some residents in western Texas, said Ron Cook, a family physician and health official who is helping doctors respond to the outbreak in Lubbock, where a child died of measles this month.
There, a handful of physicians are handing out cod liver oil to parents of sick children who are sceptical of measles immunizations, Dr Cook said. One physician told NBC News he was just trying to help families with the alternative treatment "like Bobby Kennedy is trying to do".
Vitamin A - a nutrient found in cod liver oil - is sometimes offered as a part of a treatment for measles, especially if someone is deficient, Dr Cook said. But, he added, it is difficult to monitor the levels of the vitamin in cod liver oil, which could endanger children if they are given too much of the vitamin or other nutrients it contains.
"What disappoints me the most is that they're not talking about the vaccine," Dr Cook said.
He said he believed that it was a missed opportunity to engage with vaccine-sceptical communities to help slow the spread of measles.
Kennedy, this week, offered a conditional endorsement of the vaccine, telling Fox News it was "recommended" for the Texas Mennonite community - the origin of the outbreak - while also suggesting some of the children had been harmed by the vaccines, which have been thoroughly studied and found to be safe.
This week, the Children's Health Defense, the anti-vaccine nonprofit that Kennedy founded, updated and re-promoted a 2021 book in which Kennedy called measles vaccines "risky".
"Measles outbreaks have been fabricated to create fear that in turn forces government officials to 'do something,'" he said, adding that benefits of the vaccine had been "exaggerated".