(Vancouver, WA) -- Washington state's measles outbreak stands at 54 cases. One new case was confirmed yesterday in Clark County, but another was struck from the list, leaving the tally unchanged. Clark County residents account for 53 of the cases, while the last one is in King County. Another four cases have been confirmed in Portland, Oregon. The outbreak is being blamed in part on low vaccination rates in Washington state. Meanwhile, a study published by the American Journal of Public Health yesterday claims that the Russians are behind the anti-vaxxer movement. The report says that Russia's Internet Research Agency made social media posts on both sides of the argument in an effort to erode public trust in vaccination.