As measles — a preventable disease the U.S. considered eliminated in 2000 — spreads through West Texas’ rural expanse, Klassen is sticking to an approach on vaccines that is a key tenet for Mennonites. Family leaders are the top decision-making authority — not outside recommendations, certainly not government mandates.

Measles has sickened nearly 150 mostly unvaccinated people in rural West Texas, and a school-age child has died. The virus is spreading among Gaines County’s Mennonite community, where government mandates are not trusted.

Texas’ ongoing measles outbreak is now up to 124 confirmed cases as of Tuesday. That’s the most the state has seen in any year since 1992. The measles outbreak in Texas started in Gaines County, near the New Mexico border. There are also additional confirmed cases in New Mexico and potential exposures in San Antonio and San Marcos.