COLUMBUS, Ohio (WTVN) -- A mumps outbreak in central Ohio has reached 404 cases across three counties.

220 of those cases are linked to Ohio State University. The illnesses date back to early January. The cases in Delaware, Franklin and Madison counties total a majority of reported cases nationwide. There were 438 cases nationally a year ago.

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.

Columbus Public Health spokesman Jose Rodriguez says 13 people have been hospitalized.

"Most of those have been related to pain," he said.

There has been one case of deafness, something only seen in about 1 in 20,000 cases.

Heath officials have advised college, school and daycare leaders to make sure central Ohio students are immunized and to separate them from those who have not been vaccinated and those who are infected.

"That next frontier is camps. That's where kids will be congregating over the summer," he said.

In the meantime, Ohio is also dealing with an outbreak of the measles. 206 cases have been cofirmed, all in six counties including Ashland, Coschocton, Holmes, Knox, Richland, and Wayne.