The health authorities have ratified 40 cases of Bulgarians in the northwest of the United States.
In total, 38 are in the southwestern United States, one in Seattle and another in Portland, Oregon, on Wednesday.
Two South West Washington residents visited Hawaii, where they were fifty, and they infected a third person in Bend, Oregon.
The authorities considered that no one was susceptible to pregnancy during pregnancy.
There are 13 alleged cases of Clark County Public Health.
Most confirmed cases are for children under 10 years of age.
Among all infected, only a small amount was not vaccinated against the disease.
The Washington Governor, Jay Inslee, reported last week's emergency situation.