Indiana’s department of health has confirmed the first death related to the multi-state outbreak of hepatitis A, Fox59 reports.

Hepatitis A is a highly contagious disease of the liver. It is transmitted through fecal-oral routes or by consuming contaminated food or water.

Most recently, hepatitis A has caused nearly 4,000 illnesses in 10 states, resulting in multiple deaths nationwide.

Indiana has confirmed 214 outbreak-related cases of hepatitis A since November 2017.

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"This heartbreaking loss of life illustrates how serious this outbreak is, and I urge Hoosiers to practice good hand washing and to get vaccinated, especially if they fall into a high-risk population,” Kris Box, Indiana State Health Commissioner said, according to Fox 59. “We are working with our local and federal health partners to slow the spread of hepatitis A in our state, but this disease is highly contagious and can spread rapidly, so prevention is critical.”

According to the Centers for Disease Control and Prevention (CDC), high-risk populations include people who use illicit drugs, the homeless, men who have sex with men, and the incarcerated.

More than 70 percent of those diagnosed with Hepatitis A in Indiana have reported illicit drug use, while nearly 20 percent have reported being homeless.

Indiana health officials have been working to educate the public, restaurants, jails, and groups at risk about the disease and how to prevent it.

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The Indiana State Department of Health has allocated more than $1 million to supply adult vaccines to local health departments in an effort to immunize those at risk and those who have come in contact with the disease.

Symptoms of hepatitis A include fatigue, loss of appetite, stomach pain, nausea, and jaundice. These symptoms usually occur within two months of being exposed to the virus.