A Hepatitis A outbreak has now spread to Madison and Marshall counties. We've reported for months about outbreaks in DeKalb and Jackson counties.

Dr. Karen Landers with the Department of Public Health said if there are three reported cases of Hepatitis A in a county, it's considered to have an outbreak. Now, the two new counties on the list are following plans like the ones put in place in Jackson and DeKalb counties.

Dr. Landers said the department creates a vaccine plan through on-site pharmacies at the health department, along with off-site ones.

There are three confirmed cases of Hepatitis A in Madison County and eight confirmed in Marshall County.

Right now, the state is working to coordinate vaccinations for people who are considered at-risk, and people who work with them. Landers said those groups include the homeless, and HIV and drug treatment centers. The state is also working with jails to vaccinate those populations.

Health officials say Hepatitis A is 100 percent preventable, but it can spread quickly among people who are not vaccinated.

Landers shared that because the outbreak started in the northeast corner of the state, it's not surprising it made its way west and has now entered Marshall and Madison counties. She said she wasn't aware what off-site pharmacies offer the vaccine in Madison or Marshall counties, but encourages anyone in an at-risk group to contact the health department.