A small Indiana town has seen 190 new cases of HIV infection, according to health officials. Austin, Indiana’s HIV crisis is quickly evolving into an epidemic, one that officials say “could happen anywhere,” according to USA Today.

Many people in the town, housed about 40 miles north of Louisville, Ky., the disease was believed to be one that only affected those living in “the big city.”

In Feb. 2015, the first 30 cases of HIV were reported and by mid-March, the number had climbed to 55.

Health officials in the state, the governor and the federal Centers for Disease Control and Prevention were looking for answers. And it seems like they still are as very few public health crises have unfolded so rapidly.

Now one year later, the number rest at 190. Austin, IN is a city enveloped in poverty. Fewer than 10% of the town’s residents have earned a college degree. One out of five residents lives below the poverty level. That’s more than 1.5 times the rate for the entire state of Indiana.