By Associated Press - Tuesday, April 29, 2014

MOUNT VERNON, Ohio (AP) - Ohio health officials say a measles outbreak that began among Amish who had traveled to the Philippines has grown to 26 cases confirmed over five counties.

The state Department of Health reports the number of cases in Knox County in north-central Ohio stands at 19. Ashland County has four and Richland, Coshocton and Wayne counties each have one confirmed case of the highly contagious respiratory illness.

Officials say the outbreak began with unvaccinated travelers who visited the Philippines, which has had a measles epidemic.

Officials are urging vaccination to limit the Ohio outbreak.

Measles is caused by a virus. Symptoms include fevers, coughs, rashes and pink eye.

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