Following a multi-state hepatitis A outbreak in 2017, Tennessee has been dealing with its own outbreak – an outbreak that has now infected at least 797 people across the state.

While a majority of the cases have been confined to the Cumberland and Nashville area, there have been at least 51 cases reported in East Tennessee since the outbreak began, with three staff members at Kingsport’s Indian Path Community Hospital recently contracting the illness, according to the Kingsport Times News. There have also been three deaths attributed to the outbreak.

“TDH is working with local health officials and other partners to respond to this outbreak,” the Tennessee Department of Health says on its website. “Those considered at high risk for hepatitis A infection in this outbreak include people who abuse drugs, people experiencing homelessness and men who have sex with men.”

While regular vaccinations for children have been standard over the last 10 years, many adults may not be vaccinated – despite the CDC and TDH both stating the vaccine is the best way to prevent contracting the disease.

The CDC describes hepatitis A as a highly contagious liver disease, one that can last for weeks or months in those affected. The disease is transmitted when people ingest the virus through food, objects or drinks that have been contaminated by trace amounts of fecal matter from an infected person. Symptoms may not appear for up to a month after infection, the Tennessee Department of Health warned.

On average, the state of Tennessee sees roughly 13 confirmed cases of hepatitis A, but have seen nearly 800 over the last two years. Neighboring states Kentucky and West Virginia have been faced with the highest incidence of hepatitis A in the United States thus far, with each rated a 100 out of 100 – the higher the number corresponding to a higher incidence of hepatitis A in the state, according to HepMag. Furthermore, New Hampshire health officials warned on Tuesday that they are in the early stages of their own outbreak – signaling the nation-wide outbreak has yet to be contained by health officials.

If anyone is concerned they may have been exposed, belong to one of the three risk groups or have more questions, contact the Washington County Health Department at 423-975-2200, the Northeast Tennessee Regional Health Office at 423-979-3200 or your health care provider.