In the first four months of the year alone, 33 countries reported more than 6,500 cases.

Doctors are now required to report such cases to the health department.

Twenty years later the same state reported more than 616,000 cases.

Also, the state only reports new cases, not the number of existing ones.

In Pennsylvania, officials reported three new cases for a total of seven.

The agency put out a call for doctors to report similar cases and received nearly 100 reports.

So far, the island has reported 172 cases and 18 deaths.

Mainland China reported 160 new cases over all, taking the total to 4,280.

Law enforcement officials in other states reported several cases of physical abuse.

Texas has reported 4,998 cases and 27 deaths as of July 24.