CLEVELAND — Ohio continues to fight an outbreak of hepatitis A, with nearly 2,300 cases statewide since the beginning of 2018, and the Ohio Department of Health is now committing $650,000 to help local health departments control the outbreak.

Cuyahoga County and Summit County are the two counties in Northeast Ohio with the highest numbers of hepatitis A cases as of May 20, 2019. Cuyahoga County had 38 cases and Summit County had 54 cases, according to ODH. In the city of Cleveland alone, there have been 20 cases linked to the outbreak, the Cleveland Department of Public Health said.

This map from the Ohio Department of Health shows where cases of Hepatitis A have been diagnosed across the state since the beginning of 2018.

The Cuyahoga County Board of Health and Summit County Public Health are both applying for state funding, as is the Cleveland Department of Public Health.

"I think that the funds show a commitment by the state level health department to aggressively address this outbreak," said Andrew Heffron, clinic supervisor at the Cuyahoga County Board of Health.

Heffron said the number of hepatitis A cases statewide has been steadily increasing since the outbreak began more than a year ago.

Hepatitis A is a virus that affects the liver, according to Heffron, who described some of the common symptoms as "abdominal pain, very dark yellow urine, nausea and the most common symptom that people think about is jaundice, which is yellowing of the skin."

The virus is commonly foodborne, but according to Persis Sosiak, commissioner of health at the Cleveland Department of Public Health, that's not the case in this outbreak.

"In this particular outbreak, it is much more associated with intimate contact and risky behaviors," Sosiak said.

County and local health departments are trying to reach at-risk populations through vaccination and education.

"That includes individuals incarcerated, the homeless population, men who have sex with men," Heffron said.

It also includes people traveling to developing countries and people who use illicit drugs, whether the drugs are injected or not.

The number of cases in this outbreak is much higher than in a typical year, Heffron said, and those who are most in need of vaccination are very young children and people with liver diseases such as hepatitis B or hepatitis C.

"Historically, Ohio has about 40-some cases a year, so it’s a little concerning that we’re at the numbers we’re at," Heffron said.

"The hepatitis A vaccine consists of two doses, one of which is 94 to 95% effective on its own," Sosiak said.

"We would always recommend two doses, but if even getting one, you are giving yourself or your family a high degree of protection against the infection," Sosiak said.

While medication can be given to help with hepatitis A symptoms, Heffron said the virus usually clears itself from someone's system with rest and fluids.