The measles outbreak in Texas has escalated sharply to 90 cases as health officials worry about the spread to more communities.

At least 58 cases have been confirmed. Health officials — who are scrambling to get a handle on the vaccine-preventable outbreak — suspect 200 to 300 people may be infected.

The measles outbreak in rural West Texas has grown to 90 cases across seven counties, the state health department posted online Friday, and 16 people are hospitalized.