The U.S. is having its worst year for measles spread in more than three decades, and the year is only half over.

The national case count reached 1,288 on Wednesday, according to the U.S. Centers for Disease Control and Prevention, though public health experts say the true figure may be higher.

The CDC’s count is 14 more than 2019, when America almost lost its status of having eliminated the vaccine-preventable illness — something that could happen this year if the virus spreads without stopping for 12 months. But the U.S. is far from 1991, when there were 9,643 confirmed cases.

In a short statement, the federal government said that the CDC “continues to recommend (measles, mumps and rubella) vaccines as the best way to protect against measles.” It also said it is “supporting community efforts” to tamp down ongoing outbreaks as requested.

Fourteen states have active outbreaks; four other states’ outbreaks have ended. The largest outbreak started five months ago in undervaccinated communities in West Texas. Three people have died — two children in Texas and an adult in New Mexico — and dozens of people have been hospitalized across the U.S.

But there are signs that transmission is slowing, especially in Texas. Lubbock County’s hospitals treated most of the sickest patients in the region, but the county hasn’t seen a new case in 50 days, public health director Katherine Wells said.

“What concerned me early on in this outbreak was is it spreading to other parts of the United States, and that’s definitely what’s happening now,” she said.

In 2000, the World Health Organization and CDC said measles had been eliminated from the U.S. The closer a disease gets to eradication, the harder it can seem to stamp it out, said Dr. Jonathan Temte, a family physician in Wisconsin who helped certify that distinction 25 years ago.

It’s hard to see measles cases break records despite the widespread availability of a vaccine, he added. The measles, mumps and rubella vaccine is safe and is 97% effective at preventing measles after two doses.

“When we have tools that can be really helpful and see that they’re discarded for no good reason, it’s met with a little bit of melancholy on our part,” Temte said of public health officials and primary care providers.

Wells said she is concerned about continuing vaccine hesitancy. A recent study found childhood vaccination rates against measles fell after the COVID-19 pandemic in nearly 80% of the more than 2,000 U.S. counties with available data, including in states that are battling outbreaks this year. And CDC data showed that only 92.7% of kindergarteners in the U.S. had the measles, mumps and rubella vaccine in the 2023-2024 school year, below the 95% needed to prevent outbreaks.

State and federal leaders have for years kept funding stagnant for local public health departments’ vaccination programs that are tasked with reversing the trend. Wells said she talks with local public health leaders nationwide about how to prepare for an outbreak, but also says the system needs more investment.

“What we’re seeing with measles is a little bit of a ‘canary in a coal mine,’” said Lauren Gardner, leader of Johns Hopkins University’s independent measles and COVID-19 tracking databases. “It’s indicative of a problem that we know exists with vaccination attitudes in this county and just, I think, likely to get worse.”

Currently, North America has three other major measles outbreaks: 2,966 cases in Chihuahua state, Mexico, 2,223 cases in Ontario, Canada and 1,246 in Alberta, Canada. The Ontario, Chihuahua and Texas outbreaks stem from large Mennonite communities in the regions. Mennonite churches do not formally discourage vaccination, though more conservative Mennonite communities historically have low vaccination rates and a distrust of government.

In 2019, the CDC identified 22 outbreaks with the largest in two separate clusters in New York — 412 in New York state and 702 in New York City. These were linked because measles was spreading through close-knit Orthodox Jewish communities, the CDC said.

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AP videojournalist Laura Bargfeld contributed to this report.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The number of people who have died from the flooding in Texas continues to rise, with at least 119 dead throughout the state, officials said on Wednesday morning.

Search crews continue to look for people, as residents and news organizations question the government’s alarm and warning systems.

In Kerr county, the area that was worst affected by last Friday’s flood, officials said on Wednesday morning that 95 people had died. The other 24 people who have died are from surrounding areas. The Kerr county sheriff said 59 adults and 36 children had died, with 27 bodies still unidentified.

People are slowly returning to their properties to survey the damage from the devastating flash flood, as local officials continue with rescue, recovery and cleanup efforts.

There are 161 people believed to be missing in Kerr county due to the flash floods, making up the majority of the 173 missing in the entire state. Camp Mystic, the all-girls Christian camp that was gravely affected by the flood, still has five campers and one counselor missing.

As cleanup efforts continue, more and more people are scrutinizing the government’s alert system to warn people before the flood. Journalistic investigations have revealed that first responders asked that a mass-alert system in Kerr county be triggered on Friday morning. The alert system sends text messages and “delivers pre-recorded emergency telephone messages” to some people in the area.

Dispatchers delayed a 4.22am request from volunteer firefighters for an alert to be sent, saying they needed special authorization, according to reporting from Texas Public Radio (TPR) based on emergency radio transmissions they reviewed. Some residents received flood warnings within an hour. Others told TPR they did not receive an alert until 10am – nearly six hours after first responders’ request. A separate story from KSAT confirms TPR’s reporting.

There are inconsistencies regarding local officials’ response. In his first press conference on 4 July after the flood, the Kerr county judge said the area did not have an emergency alert system.

“I believe those questions need to be answered, to the families of the missed loved ones, to the public, you know, to the people who put me in this office. And I want that answer and we’re going to get that answer,” the Kerr county sheriff, Larry Leitha, said.

“We’re not running, we’re not going to hide. That’s going to be checked into at a later time.”

There are no outdoor weather sirens to blast alerts in some communities in the area. Since 2015, Kerr county officials have applied for grants for a flood warning system, the New York Times reported. For years, officials have also warned the series of summer camps in the area of incoming floods by word-of-mouth. A Change.org petition was launched after the flood for an early warning siren system and has more than 35,000 signatures.

Rescue and recovery efforts are continuing. The Kerr county sheriff’s department is working on rescue and recovery efforts, the sheriff said, adding that it was an “all hands on deck” situation.

During Wednesday’s press conference, local officials asked people to be careful and give search crews space during their efforts. “We are using very heavy equipment” to search and clear up fallen trees and debris, a sheriff official said.

On Sunday, the Trump administration declared the flooding a “major disaster” and deployed federal resources to assist the state.

WASHINGTON — President Donald Trump’s push for Republicans to bypass Democrats and claw back $9.4 billion in approved spending has ignited a new fight in Congress that could upend the normally bipartisan government funding process.

Ahead of a Sept. 30 deadline to prevent a shutdown, Senate Minority Leader Chuck Schumer, D-N.Y., is laying down a marker by warning that Democrats won’t sign off on an agreement if the GOP follows through with Trump’s request.

“If Republicans cave to Donald Trump and gut these investments agreed to by both parties, that would be an affront — a huge affront — to the bipartisan appropriations process,” Schumer said. “It is absurd to expect Democrats to play along with funding the government if Republicans are just going to renege on a bipartisan agreement by concocting rescissions packages behind closed doors that can pass with only their votes, not the customary 60 votes required in the appropriation process.”

Schumer’s warning represents a bold gambit that heightens tensions ahead of another government funding showdown — just months after a group of Senate Democrats backed down from a previous showdown and drew heavy backlash from their base.

The dynamics are the product of a quirk in Senate rules. Funding the government is subject to the filibuster, requiring 60 votes, but a separate —and rarely used — process allows for canceling some approved spending with a simple majority vote.

The rescissions package would slash $8.3 billion in foreign aid and $1.1 billion from the Corporation for Public Broadcasting, which funds PBS and NPR. It flows from efforts by Elon Musk’s erstwhile Department of Government Efficiency, or DOGE, to find savings.

It passed by House last month by a vote of 214-212. It’s unclear if the Senate, where Republicans control 53 seats, has enough votes to pass it. Some GOP senators want to make changes, which would send it back to the House.

Democrats staunchly oppose the rescissions package, which was crafted without their input. Republicans can pass the $9.4 billion in cuts on party lines, but if that leads to Democrats refusing to sign off on a new government funding deal, it could trigger a shutdown at the end of September.

Senate Majority Leader John Thune, R-S.D., said Wednesday he will bring up the rescission package “next week” and that it will be subject to an open amendment process.

Thune said he was “disappointed” to see Schumer “implicitly threaten to shut down the government.”

“But I’m hopeful that that is not the position of the Democrat Party, the Democrat conference here in the Senate, and that we can work together in the coming weeks to pass bipartisan appropriations bills,” the majority leader said.

Congress has a deadline of July 18 to send the rescissions package to Trump’s desk, or let it dissolve.

Even some Republicans worry that canceling spending on party lines would harm the traditional appropriations process.

“And the reason for that is because, if you do appropriations in the Senate, you have 60 votes to support it. If you do rescissions, you can take it back with 50, which then makes it tougher to get a bipartisan agreement on an appropriations package,” Sen. Mike Rounds, R-S.D., who sits on the Appropriations Committee, told NBC News. “We are aware of the sensitivities of using a rescissions package versus the appropriations process.”

Beyond that, Rounds said the measure must be revised to protect rural broadcast stations who could lose critical funding.

“We have to have a fix, for sure, on those rural radio stations. Basically 90% or more of their resources are taken away by the rescissions package,” he said. “OMB has agreed to work with us, and now we’re in that process of finding the appropriate path forward where they do not lose their funding.”

And Sen. Susan Collins, R-Maine, the Appropriations Committee chair, said she opposes some parts of the measure.

“For my part, I believe it needs some significant changes,” Collins said, citing the President’s Emergency Plan for AIDS Relief (PEPFAR) as a program she “can’t imagine why we would want to” cut funding from.

Sen. Thom Tillis, R-N.C., said he’s inclined to support the measure, but he’s reviewing parts of it, including PEPFAR.

“I’m fine with the majority of it,” Tillis said. “We’re just looking at any of the national security impacts, any nexus there that would raise concern.”

Schumer’s threat to block an appropriations deal would require at least 41 of the 47 Democrats to rally against it, a level of unity they failed to achieve in March during a contentious spat over a looming government shutdown.

Sen. Tammy Baldwin, D-Wis., an Appropriations Committee member, said if Trump and the Republican majority “can undermine the appropriations process by rescinding bipartisan funding on a simple majority vote, that presents real challenges to the appropriations process.”

“Moving forward, it’s our job, in the next few days to make sure that Republicans know that this would be a major trust factor in moving forward with our appropriation bills,” she said.

Bobby Kogan, a former Senate Democratic budget aide who is now at the liberal Center For American Progress, said the GOP effort could break the appropriations process as its currently known.

It doesn’t help, he added, that Trump and his party already modified part of government funding with a major increase in spending for the military and immigration enforcement under the party-line megabill the president signed into law last week.

“This all risks a lot more shutdowns. Republicans are looking at breaking appropriations deals on both sides of the ledger: spending more on the things they like and less on the things they don’t like,” Kogan said. “If you can break bipartisan appropriations deals with partisan rescissions packages, that is going to be the end of bipartisan appropriations.”