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 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.

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.

But there are signs that transmission is slowing, especially in Texas. Lubbock County’s hospitals treated most of the sickest patients in the region, but the county hasn’t seen a new case in 50 days, public health director Katherine Wells said.

“What concerned me early on in this outbreak was is it spreading to other parts of the United States, and that’s definitely what’s happening now,” she said.

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 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.