DENVER (AP) — State health officials are warning hospitals to be on the lookout for potential mumps patients as four cases have been confirmed in Denver and two other probable cases are under investigation.

The Denver Post reports that the Colorado Department of Public Health and Environment issued the warning Tuesday. The department says the latest cases may be linked to a mumps outbreak in Iowa.

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Officials say a person who recently moved to Colorado from Iowa reported symptoms of the disease in January and that three of their friends also fell ill. The group was evaluated and all tested positive for mumps on Feb. 2.Mumps symptoms include fever, headache, muscle aches and swollen salivary glands. The virus can be spread by coughing, sneezing, talking and other means.