SANTA ANA, Calif. — The measles outbreak centered in California continues to expand, with officials now confirming 78 cases of the illness in seven states and Mexico.

The California Department of Public Health said there are now 68 cases in the state — 48 that have been directly linked to being at Disneyland or Disney California Adventure last month. Some people also visited one or both of the parks while infectious in January.

The measles outbreak also has spread beyond those who visited Disneyland in December and January and is infecting people in the broader community.

Nine counties in California have confirmed measles cases: Alameda, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, Santa Clara, and Ventura. Cases connected to visiting Disneyland also have been confirmed in Utah (3), Washington state (2), Oregon (1), Colorado (1), Arizona (1), Nebraska (1) and Mexico (1).

The California patients range in age from 7 months to 70 years. The vaccination status is known for at least 34 of the patients. Of those, 28 were unvaccinated, one had received partial vaccination and five were fully vaccinated.