() As the country faces a deadly measles outbreak, funding cuts are hitting public health offices that work to track and prevent measles.

Roughly 20 states have reported measles cases, with Texas at the center of the outbreak. The hardest-hit state is now seeing the impact of federal cuts.

In Dallas County, three of the funding grants from the Centers for Disease Control and Prevention have been impacted by a federal funding freeze. Early estimates from officials say that could be in the millions of dollars.

Nationwide, there is an expected loss of about $11.4 billion from community health departments nationwide.

As a result, 50 vaccination clinics in Texas have been scrapped, places that were working to combat the outbreak that has spread largely among those who are unvaccinated.

More than 20 public health workers have also been laid off, including those who administer vaccines and lab staff who are tasked with measles surveillance and prevention.

Since January, Texas has reported more than 420 measles cases, according to the Department of Health, and the funding cuts are hampering local efforts to contain the spread.

Public health departments have been left scrambling, with fears that the number of cases will go up as the cuts limit surveillance efforts and access to vaccines.

For now, they are relying on systems that are still in place, including networks of clinics, to administer the vaccine while also sounding the alarm about the outbreak.