The Philadelphia Department of Public Health, working with Temple University Student Health Services, said 46 of the cases are in Philadelphia, and the other three are from surrounding counties.
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The department and Temple are urging anyone with symptoms to see their regular doctor or go the Student Health Services.
Symptoms include fever, fatigue, headache, and pain along the jaw, neck or pelvic area. The health department recommends plenty or rest, lots of water, and over-the-counter anti-inflammatory medication.