With a month still to go, 2016 is already the worst year for mumps outbreaks in a decade. Despite widespread vaccination requirements, college campuses are bearing the brunt of the attack as students live in close quarters and don’t always maintain the healthiest lifestyles.

As of Nov. 26, the latest date available, the Centers for Disease Control and Prevention had recorded 3,832 provisional mumps cases across 45 states and Washington, D.C. That’s nearly triple the 2015 total of 1,329 and the highest tally since 2006.

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