MOUNT VERNON, Ohio (AP) - Health officials say 83 cases of measles have been confirmed in an Ohio outbreak that began among Amish who had traveled to the Philippines, which has had an epidemic. The state Department of Health reports cases of the highly contagious respiratory illness in six Ohio counties. Knox County has the most with 52, four of whom were hospitalized. Neighboring Ashland County has 14 cases, with one hospitalization. There are eight cases in Holmes County, six in Coshocton County, two in Wayne County and one in Richland County. Officials are urging vaccination to limit the spread of measles and of mumps, which has caused a separate outbreak in central Ohio. Measles is caused by a virus. Symptoms include fevers, coughs, rashes and pink eye.