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. 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. 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.