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.

The number of measles cases associated with an outbreak in Texas has increased to 159 -- an increase of 13 cases in the past five days, authorities said on Tuesday.