The number of mumps infections has risen by three as of today as the state records its highest number of cases in at least a decade.

The three new cases were reported in East Honolulu and Waipahu, the Department of Health reported.

The total number of cases in 2017 is now up to 23.

Mumps is caused by a virus and typically begins with fever, headache, muscle aches, tiredness and appetite loss followed by swollen salivary glands. There is no specific treatment for mumps infection, but the Health Department recommends staying home from school or work for nine days after the onset of swelling to keep from spreading the disease.

On April 28, state health officials confirmed 14 cases and said they had become aware of two clusters of cases. They said more people are likely to come down with the contagious disease in coming weeks.

Last year Hawaii had 10 cases of mumps. Before that, the most for any single year going back to 2007 was five.