By Sy Mukherjee
April 23, 2018

Happy Monday, readers—I hope you had a wonderful weekend. This is Sy.

Indiana health officials are urging residents who plan on traveling to Kentucky or Michigan to get Hepatitis A vaccines as an outbreak of the virus in the states leads to a mounting death toll ahead of the summer travel season.

The Kentucky Hepatitis A outbreak has infected more than 300 people across multiple counties and killed at least three. The situation is even more concerning in Michigan, where more than 800 Hepatitis A cases have been reported alongside more than two dozen deaths. Indiana is also reporting a larger number of hep A infections this year compared with 2017, leading public health experts there to push vaccines for those who haven’t already received immunizations.

Here’s what we know so far about this latest outbreak.

Why is this Hepatitis A outbreak spreading?

Officials have yet to trace the new Hepatitis A outbreaks in these states to a specific root cause. But one theory posits that a lack of stricter vaccination requirements decades ago means that some older residents may have never gotten their hep A shots.

Hepatitis A’s spread (and it’s not just limited to Kentucky, Michigan, and Indiana—west coast states like California have been grappling with the scourge, too) could theoretically be the combined effect of unvaccinated individuals and tainted substances such as food. After all, as the CDC points out, after a sharp downward trend in these viral infections for more than a decade, the reported number of cases began picking up again about five years ago.

“[T]he first increase between 2012 and 2013 (1,562 and 1,781 reported cases, respectively), was due to a large multi-state outbreak,” says the agency. “Between 2015 and 2016, the reported cases again increased by 44.4% from 1,390 in 2015 to 2,007 cases in 2016. The 2016 increase was due to two [hep A] outbreaks linked to imported foods.”

Hepatitis A cases by year, courtesy of CDC

What is Hepatitis A and its symptoms?

Hepatitis A is an infectious viral disease that attacks the liver. It’s pretty easily prevented via Hepatitis A vaccines and common sense public health practices such as washing your hands, according to the Centers for Disease Control (CDC); but it’s also highly contagious, spread through contact with an infected person or tainted food and water.

Hepatitis A symptoms include various flu-like aches and pains, including fever, fatigue, nausea, vomiting, and abdominal and other pains. It can afflict children and adults alike. But one key difference between Hepatitis A and its viral cousins Hepatitis B and Hepatitis C is that it’s usually short-term and doesn’t become a long-lasting chronic condition. There are also vaccines out there to prevent Hepatitis A and B; the same cannot be said for Hepatitis C.

The Hepatitis A vaccine—how long does it last?

Public health officials in states affected by this latest outbreak emphasized that “all children, ages 1 year through 18, [should] receive the Hepatitis A vaccine, as well as adults who want to prevent themselves from an acute Hepatitis A infection,” as Kentucky Department of Public Health (DPH) acting commissioner Dr. Jeffrey Howard recently said in a statement.

The full vaccination course involves taking two shots, about six months apart. The first shot alone can provide protection—including if you’ve already been infected (as long as it’s administered quickly enough), the CDC says. Following the vaccination schedule fully (or being infected and then recovering from Hepatitis A) usually offers lifelong protection—which is a big part of the reason that Hepatitis A rates have plummeted a stunning 95% since the vaccine was introduced in 1995.

Read on for the day’s news.

Sy Mukherjee
@the_sy_guy
sayak.mukherjee@fortune.com

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