Health officials are investigating the cause of 45 cases of mumps in Dubuque County, more than half of all cases in Iowa. 
Dubuque County Health Department executive director Patrice Lambert says this is the worst mumps outbreak in a decade, and the source of the has not yet been determined.

According to KCRG, 30 of the 45 cases in Dubuque County have been students. The entire state has had a total of 88 cases of the mumps. That means Dubuque County alone has more mumps cases than all other counties in the state combined.

Lambert advocated following the "three Cs" to prevent disease spread — cleaning hands frequently, covering coughs and containing the illness by avoiding public places. She said the recommendation is similar to preventing influenza spread.

The Telegraph Herald reports that precautions are being taken to try and halt the spread of the disease, which can cause fever, headaches and swollen salivary glands.