The U.S. has recorded more than 1,100 measles cases so far this year, according to data published Friday by the U.S. Centers for Disease Control and Prevention. It’s a troubling milestone that has many in public health bracing for the worst.

According to the CDC, out of every 1,000 children who are infected with measles, one may develop encephalitis, which is a dangerous swelling of the brain. Up to three out of every 1,000 infected children will die.

The U.S. is on track for another record-breaking year for measles: The number of measles cases reported in the first eight weeks of the year — 1,136 as of Feb. 26, according to CDC data — is already six times more than typical for an entire year. A tracker from the Johns Hopkins University Center for Outbreak Response Innovation has tallied an even higher annual case total than the CDC.