Measles outbreaks are spreading across the U.S., and the nation is likely to lose its status as a country where the disease is eliminated, something that infectious disease specialists say is directly related to Trump’s appointment of Robert F. Kennedy Jr. as secretary of the Department of Health and Human Services (HHS).

South Carolina this week quarantined at least 254 people after confirming more than two dozen measles cases in the state. It’s the latest in what has been the worst year for measles in the U.S. in recent history.

An outbreak in West Texas this year saw more than 700 confirmed cases since January and the deaths of two children. According to the Centers for Disease Control and Prevention (CDC), there have been 47 reported outbreaks in the country this year.