COLUMBUS, Ohio (AP) -- Public health officials say a mumps outbreak in central Ohio has reached 321 cases, with Madison County now added to the outbreak.
The cases in Delaware, Franklin and Madison counties total about three-quarters of reported cases nationwide.
The running total of the cases of the contagious viral illness was reported by Columbus health officials as of Tuesday, with 191 of those linked to Ohio State University.
Mumps often starts with fever, fatigue and body aches. Those infected are urged to stay home, cover their mouths and noses when coughing or sneezing, and frequently wash their hands.
Heath officials have advised college, school and even day care leaders to make sure central Ohio students are immunized and to separate them from those who haven't been vaccinated and those who are infected.