The Ohio Department of Health has declared a statewide outbreak of hepatitis A virus (HAV), making it the 10th state to do so since 2017, NBC’s WNDU reports. 

State surveillance stats show Ohio has had 82 cases so far in 2018, twice as many as were reported last year. Many of the new infections have been linked to a multistate outbreak currently occurring across Arkansas, California, Indiana, Kentucky, Michigan, Missouri, Tennessee, Utah and West Virginia.

In response, the state health department has provided more than 5,000 doses of the hepatitis A vaccine to local health departments across Ohio. Officials are also recommending increased vigilance around handwashing to help prevent infection among at-risk individuals.

At-risk groups include people with direct contact with others who have been diagnosed with HAV, travelers to countries with high or intermediate rates of the virus, men who have sex with men (MSM), injection and non-injection drug users, people with clotting factor disorders, household members and other close contacts of children recently arrived from countries with high HAV rates, homeless people, refugees and those with irregular access to clean water or bathing facilities. 

The hepatitis A vaccine is currently recommended for younger children, older adults (who may never have been vaccinated) and those with weakened immune systems. The CDC also suggests that people recently exposed to the virus get a preventive shot.

Click here for Hep’s interactive map tracking hepatitis A outbreaks in the United States.