The Hepatitis A virus is reportedly spreading across the country in the wake of the opioid crisis, mostly affecting drug users and the homeless.

According to a recent report by USA Today:

Relentlessly, the virus continues its march across the nation. Pennsylvania declared an outbreak as recently as May. In early August, Florida and Philadelphia declared public health emergencies, which, among other things, signal to health care providers the need to vaccinate the vulnerable. Case counts now exceed 1,000 in six states.

The report said that since 2016, 29 states including Michigan and California experienced outbreaks. Across the U.S., more than 23,600 people were infected and over 230 people died from it.

A report by the Centers for Disease Control and Prevention (CDC) said people who use drugs and individuals experiencing homelessness are among those who are at the highest risk of being infected.

Breitbart News reported in 2017 that Michigan saw an uptick in the number of infection cases since the beginning of an outbreak the year before.

“An outbreak of Hepatitis A in Michigan that began in August 2016 has seen the number of cases reported in 2017 increase by a factor of ten since 2015, the last full year of reporting prior to the current outbreak,” the report said.

On August 1, Florida Surgeon General Dr. Scott Rivkees declared a public health emergency after 56 cases of Hepatitis A were reported during the last reporting period.

“I am declaring this Public Health Emergency as a proactive step to appropriately alert the public to this serious illness and prevent further spread of Hepatitis A in our state,” Rivkees said.

“The best way to prevent Hepatitis A is through vaccination. It is important that we vaccinate as many high-risk individuals as possible in order to achieve herd immunity,” he concluded.

Hepatitis A is caused by a virus that infects the liver and can be spread through the feces of those infected. Individuals must wash their hands with warm soap and water after using the bathroom in order to stop the virus from spreading.

Symptoms of the virus include fever, fatigue, vomiting, joint pain, and jaundice.