Health authorities have confirmed 40 cases of measles in the Northwestern United States.
Of this figure, 38 are in the southwestern part of the state of Washington, one in Seattle and one outside Portland, Oregon, officials said Wednesday.
Two of the patients in the southwestern part of Washington visited Hawaii, where they were quarantined, and a third person was infected during a visit to Bend, Oregon.
Officials believe no one was exposed to measles in Hawaii.
Clark County's public health department says there are 13 other suspected cases.
Of the confirmed cases, the majority corresponds to children under 10 years of age.
Of all those infected, only a few were vaccinated against the disease.
Washington's governor, Jay Inslee, declared a state of emergency early this week because of an epidemic.