The Nassau County Health Department has confirmed that a limited outbreak of mumps appears to be spreading in Long Beach.

As News 12 has reported, 18 cases of the highly contagious respiratory infection were first reported in the beginning of August. That is when health officials said the majority of people affected had already been vaccinated against the disease.

Health officials say 18 more cases of mumps have been confirmed in Long Beach since then. The new cases bring the total number of recent cases to 36.

Most of the original confirmed cases of the mumps were in young adults, many of whom are heading back to college campuses throughout the country. Officials say the mumps has now reached 40 states and affected many college campuses.

Symptoms include swelling on one or both sides of the neck, low-grade fever, fatigue and headache.

The Centers for Disease Control and Prevention recommends the MMR vaccine and hand-washing.