The Texas measles outbreak that sickened 762 people since late January is over, state health officials said Monday.

Health officials have not confirmed a new case in the affected counties in more than 42 days, passing the threshold used to declare measles outbreaks over. The last outbreak-related case in Texas was on July 1, according to state data.

Two young Texas children died of the virus earlier this year and 100 people were hospitalized throughout the outbreak. The cases were linked to outbreaks in Canada and Mexico and jumped to other states in the U.S.

The U.S. is having its worst year for measles in more than three decades, with 1,356 cases as of Aug. 5. Nationwide, childhood vaccination rates against the virus are declining as more parents claim exemptions from school requirements.

West Texas was the nation’s measles epicenter for months. The virus started spreading there in close-knit, undervaccinated Mennonite communities in Gaines County.

State officials say they will keep monitoring for new cases. Before the outbreak, most doctors in the state had never seen a measles case because of how uncommon it has become, said Texas Department of State Health Services Commissioner Jennifer Shuford.

She credited testing, vaccination, monitoring and education with helping to end the outbreak.

“I want to highlight the tireless work of the public health professionals across the state who contributed to the containment of one of the most contagious viruses,” Shuford said in a statement.

Measles causes a rash and respiratory symptoms that can lead to severe complications or death. It is prevented by the measles, mumps and rubella vaccine, which is recommended for young kids before they start school.

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