Kentucky's latest death from hepatitis A reported this week by the state health department raised the toll to 58 in the nation's largest outbreak of the contagious liver virus.

The vaccine-preventable disease, spread mostly among drug users, has sickened 4,682 Kentuckians since the outbreak was declared in November 2017, the report said.

But compared with a high of 151 new infections a week at its peak last fall, only 14 new cases were recorded in the week ending May 25.

Department for Public Health Commissioner Dr. Jeffrey Howard has said prevention efforts, including vaccinating the at-risk, would continue because cases could still rebound.

Spread person-to-person, the virus has hospitalized 48% of its victims and has hit 90% of Kentucky's 120 counties, with 10 counties reporting new cases in the week ending May 25.

CJ investigation:Kentucky's 'too slow' response to the nation's worst hep A outbreak

Kentucky's outbreak first hit in Louisville, where officials began to contain it by late spring 2018 after an aggressive response. But around the same time, it exploded across rural Kentucky, catching fire to the state's vast rural drug abuse epidemic.

Some key former state health department officials and advocates criticized Kentucky's response in its rural areas as sluggish, arguing health leaders failed to mount a more aggressive and costly response that could have meant fewer illnesses and expensive hospitalizations.

A Courier Journal investigation found that last spring, the state's former infectious diseases chief, Dr. Robert Brawley, recommended $6 million for vaccines and $4 million for temporary workers to help thinly staffed local health departments deliver vaccines to hard-to-reach drug users.

He also called for a public health emergency declaration to help pave the way for federal assistance.

But Howard, citing limited funding and the local reserves that some health departments had, sent $2.2 million in state funds to local health departments and declined to seek an emergency declaration.

Previously:Kentucky racks up one-third of all hepatitis A deaths in US

Kentucky's deaths have since accounted for nearly one-third of 185 deaths nationally from similar outbreaks, which since 2016 have spread to 22 states infecting more than 19,000 people, according to the Centers for Disease Control and Prevention.

Michigan has had the second-highest numbers of deaths, with 28.

Brawley earlier this month said the public "should be outraged" about what he called a "slow-motion public health response."

Howard and other state health officials have argued the state's overall efforts to stem the outbreak were hobbled more by logistical challenges of reaching drug users than money. About 19% of those infected are not in risk grounds of drug users or the homeless.

He has since deployed a roving team of nurses to administer vaccines in rural county jails to help counter the virus, and taken other measures, officials said recently.

In the recent report, only Christian, Hopkins, and Pulaski counties reported at least five new cases within the last month.

More:Kentucky congressmen question why officials didn't act faster in hep A outbreak

Reporter Chris Kenning can be reached at ckenning@gannett.com or 502-582-4307.