INDIANAPOLIS (AP) — Indiana health officials say six more state residents who've tested positive for a mosquito-borne virus that has quickly spread through the Caribbean include four teens who recently traveled on mission trips to the region.

The new cases reported Thursday by the Indiana State Department of Health brings to seven the total number of confirmed cases in the state of chikungunya virus. The agency says most of the seven people have confirmed travel to the Caribbean. Mosquitoes in the U.S. don't appear to carry the virus.

The agency didn't say where the latest people to test positive live. The first case was reported in a Fort Wayne-area resident last month.

The virus rarely causes death but symptoms including high fever and joint pain can be severe.