The Indiana State Department of Health (ISDH) has confirmed the state’s first death related to a multi-state outbreak of hepatitis A, a highly contagious disease of the liver. The outbreak has caused nearly 4,000 illnesses in 10 states and resulted in multiple fatalities nationwide. No additional details about the patient will be released due to privacy laws. Since November 2017, ISDH has confirmed 214 outbreak-related cases of hepatitis A. Indiana typically sees about 20 cases in a 12-month period. Over the past several months, Indiana health officials have been working to educate the public, restaurants, jails and groups that serve at-risk populations about the outbreak and ways to prevent the disease. ISDH has allocated more than $1 million in additional state and federal funds to supply adult vaccine to local health departments, which are working to immunize those who are at risk or who may have come in contact with the disease. Hepatitis A is usually transmitted person-to-person through fecal-oral routes or by consuming contaminated food or water. The Centers for Disease Control and Prevention (CDC) identifies those most at risk during this outbreak as people who use illicit drugs, the homeless, men who have sex with men and those who are incarcerated. More than 70 percent of the individuals diagnosed with hepatitis A in Indiana have reported illicit drug use, while nearly 20 percent have reported being homeless. Indiana law has required a hepatitis A vaccine for school admission since 2014, so most students preparing to enter fourth grade and younger have already been vaccinated. Hepatitis A vaccine is readily available from health care providers and pharmacies as routine preventive care. Anyone who is exhibiting symptoms of hepatitis A should contact a healthcare provider immediately and refrain from preparing food for others. Symptoms can include fatigue, loss of appetite, stomach pain, nausea and jaundice, which usually appear within two months of infection. Individuals can become ill 15 to 50 days after being exposed to the virus. A doctor can determine if someone has hepatitis A with a blood test. Visit the ISDH hepatitis A outbreak website (https://www.in.gov/isdh/27791.htm) for updates, and the CDC website (https://www.cdc.gov/hepatitis/outbreaks/2017March-HepatitisA.htm) for national outbreak information.