Volusia County has 174 of the state's 1,978 hepatitis A cases. Prevention measures include vaccinations and hand washing.

The number of hepatitis A cases is still rising in Volusia County and statewide, according to the Florida Department of Health.

The most recent data through July 20 shows Volusia still has the third-highest number of cases in the state with 174, falling behind only Pasco County with 355 and Pinellas County with 323.

[READ MORE: Free school immunization shots available in Volusia, Flagler]

Statewide there are 1,978 cases — well over three times the number of cases reported in all of 2018. Cases have been reported in 54 of the state's 67 counties.

[READ MORE: Hepatitis A cases skyrocket in Volusia County to 4th highest in Florida]

What is it?

Hepatitis A is a highly contagious liver infection that can range from a mild illness that lasts a few weeks to severe, lasting months. Although rare, some people can die from the infection, mostly those 50 and older or people with other liver diseases, according to the Centers for Disease Control and Prevention.

What are the symptoms?

Symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, diarrhea, clay-colored stools, joint pain and jaundice, which is yellowing of the skin and eyes. They usually begin four weeks after exposure and develop over several days.

How is it spread?

According to the state department of health, hepatitis A can be spread through food or drink that has been contaminated with fecal matter from those infected. The CDC says it can also be spread through close personal contact with an infected person such as sex or caring for someone who is ill. Those traveling to countries with high rates of hepatitis A are also at risk.

Volusia's high risk groups

Intravenous drug users, the homeless and those who recently have been or are incarcerated are considered at high risk for the disease. Hepatitis A outbreaks at the Volusia County Branch Jail have forced four or five quarantines at the facility in the past six weeks.

Prevention

Health officials say the best line of defense against hepatitis A, aside from frequent hand washing, is to get a vaccination. The vaccination is given as two shots six months apart.

Where to get a vaccination?

The department of health offers the vaccine at no cost to those in the three high-risk groups. For others, the cost of the shot without insurance is $62.50. If a person demonstrates financial need, the vaccine is provided on a sliding scale. The vaccination is also available at local pharmacies.