Samoa said Sunday its death toll from measles has risen to 68, with three fatalities recorded in the previous 24 hours.
The Health Ministry has confirmed 4,581 cases of the disease. Most of the victims have been young children.
The South Pacific island has declared a state of emergency, closing all schools and banning children from public gatherings.
"Your own son [dying] is the most complicated and painful thing in life," Alieta Iosefa said at her 10-year-old son's funeral. The anguished mother said her son was a "cancer survivor" who "caught from the hospital, the germs of measles." She said her son's immune system was "very low."
The ministry said Saturday almost 90% of its population has received the measles vaccine.
The worldwide measles vaccination rate has "stagnated for almost a decade," the World Health Organization reports.
Samoa's measles vaccination rate tumbled from 59% in 2017 to 31% in 2018, according to WHO and UNICEF, "largely due to misinformation and mistrust among parents."
This year the United States reported the most cases of measles in 25 years.
Last year, four European countries — Albania, the Czech Republic, Greece and the United Kingdom — lost their measles elimination status after "protracted outbreaks of the disease," according to WHO.
Samoan authorities think a traveler from New Zealand introduced the measles virus.