The Massachusetts Department of Health has reported a statewide hepatitis A virus (HAV) outbreak after 65 people were recently infected, including one person who died from infection-related complications, Boston 25 News reports.

As of this week, the state has issued a public health alert for those experiencing homelessness, addiction and/or substance use disorders. Officials say 45 percent of cases so far have been located in Boston, with an increasing number in other cities and towns across the state.

In response, local health officials are urging people to get vaccinated against the virus. They are also encouraging local health departments to work with clinical and community-based agencies to address the crisis. Their recommendations include educating at-risk communities about hepatitis A and offering vaccines to those who need them.

Since hepatitis A is transmitted primarily via fecal-oral contact, the virus can most easily be prevented through handwashing and proper sanitation. Homeless individuals are at particularly high risk for infection, since many lack access to proper showers, hygiene stations or bathrooms.

Massachusetts is the latest in a long line of states to face a homelessness-related hepatitis A outbreak this year. Similar alerts have been issued in California, Kentucky, Minnesota, Tennessee, Colorado and more.