Indianapolis, in. — Kentucky and Michigan have reported significant outbreaks of hepatitis A, a highly contagious viral infection of the liver. Kentucky has more than 300 cases, the majority of which have occurred in the Louisville area, and Michigan has more than 800 cases, including 25 deaths. Indiana, which typically sees fewer than 20 cases of hepatitis statewide each year, has confirmed 77 cases since January, many of which are related to an outbreak in southern Indiana.“With popular tourist events coming up in other states, we know many Hoosiers will be traveling to areas impacted by hepatitis A, and we want them to be safe,” said Deputy State Health Commissioner and State Epidemiologist Pam Pontones. “Getting vaccinated and thoroughly washing your hands before and after preparing food and eating and after using the restroom are simple, safe and effective ways to prevent the spread of hepatitis A.”Symptoms of hepatitis A vary and may include loss of appetite, nausea, fatigue, fever, stomachache, dark (cola) colored urine and light colored stools. Jaundice (yellowing of the eyes or skin) may appear a few days after the onset of these symptoms. Individuals can become ill 15 to 50 days after being exposed to the virus. Most people who get hepatitis A feel sick for several weeks, but they usually recover completely and do not have lasting liver damage. However, hospitalization and, in rare cases, death can occur. Anyone who is exhibiting symptoms of hepatitis A should contact a healthcare provider immediately and refrain from preparing food for others. Hepatitis A virus is usually spread through feces (stool) of infected people but may also be spread through injection drug use.Since 2014, Indiana has required children to be immunized against hepatitis A prior to entering school. However, anyone who may be at risk, especially food handlers in schools, hospitals, restaurants, correctional institutions and other facilities that serve large numbers of people, is urged to get vaccinated. Hepatitis A vaccine is readily available from health care providers and pharmacies as routine preventive care.Healthcare providers are encouraged to ask patients about risk factors for hepatitis A, including:Travel to locations with high rates of hepatitis AMen who have sex with menInjection drug useA diagnosis of chronic liver diseaseDirect contact with individuals who have hepatitis AFor more information on hepatitis A, visit the ISDH website.