The outbreak of measles in a small West Texas community may be worse than officials originally thought. They are scrambling to promote vaccinations.

The measles outbreak first reported in Gaines County, Texas, has doubled to 48 cases since a count released earlier this week, the Texas Department of State Health Services said Friday. The first two cases were identified in late January and the numbers have been rising since.

At least 49 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.