It’s never a good sign when measles is in the news. The current US outbreak is continuing to grow in several states, leading to the most CDC-confirmed cases — 1,753 — the country has seen in 33 years.

An outbreak in Texas that began in January was declared over in August, but experts say the strain developed in that community is the one that’s still spreading now, per the New York Times. An outbreak in Utah and Arizona is currently the largest in the country, with more than 180 cases.

But the Southwest isn’t the only region affected. Last month’s outbreak in South Carolina, tied to two schools, led to students being quarantined after exposure to the virus. Recent cases have also been confirmed in New York.

In total, the CDC reports that there have been 45 measles outbreaks in 41 states

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