With a new confirmed case last week, the Barren River District Health Department has now seen 27 confirmed cases of hepatitis A this year, according to Layne Blackwell, the regional epidemiologist for the agency that serves Barren, Butler, Edmonson, Hart, Logan, Metcalfe, Simpson and Warren counties.

In the 10-county Barren River region – which also includes Monroe and Allen counties – there have been 132 cases since a nationwide hepatitis A outbreak began nearly two years ago, according to the most recent report from the Kentucky Cabinet for Health and Family Services. Allen County had the region’s highest number with 46 cases and also the highest rate at 219.7 per 100,000 people. There were 44 cases in Warren County, 16 in Barren, 11 in Butler, seven in Simpson and two or less in the other counties.

“Prevention remains crucial,” Beth Fisher, spokeswoman for the Kentucky Cabinet for Health and Family Services, said in an email. “Vaccination is recommended for high-risk groups and for anyone living in counties experiencing an outbreak. The Department for Public Health is currently focused on correctional facilities as a way of reaching high-risk individuals who have not been vaccinated.”

Since 2016, the U.S. has struggled to eliminate an outbreak of hepatitis A. The outbreak hit Kentucky on Aug. 1, 2017. Through June 1, the state has reported nearly 4,700 cases, including 629 confirmed, 2,750 probable and 1,316 suspected cases. There have been 2,267 hospitalizations and 58 deaths, according to the report.

That’s the highest case count in the nation, and the 58 deaths represent nearly a third of all national outbreak-associated deaths.

In the past month, there were 72 new outbreak-associated cases, mostly in the southeastern region. Nearby, Hopkins County reported 10 new cases, and Christian County reported five new cases.

Illicit drug use has remained the predominant risk factor for outbreak-associated acute hepatitis A cases, and homelessness is another risk factor. But nearly 20 percent of cases – 723 – did not possess any outbreak-related risk factors.

Hepatitis A spreads the fecal-oral route (such as not washing hands after using the restroom) or through the consumption of contaminated food or water, according to the Centers for Disease Control and Prevention.

Over the weekend, Kroger stores began recalling purchases of “Private Selection” frozen triple berry medley and frozen blackberries. The U.S. Food and Drug Administration is warning consumers that these fruits have been contaminated with hepatitis A and recommends that anyone who has eaten the products and has not been vaccinated for hepatitis A should visit a doctor.

The FDA and the CDC have not reported any cases of hepatitis A linked to these products.

Food contamination, spread through poor sanitary conditions or poor personal hygiene, can occur during growing, harvesting, processing, handling and after cooking.

It’s uncommon that the virus spreads through water in the U.S. The chlorination of water kills viruses that enter the water supply, and the FDA monitors recreational waters for fecal contamination.

– Follow reporter Caroline Eggers on Twitter @eggersdaily news or visit bgdailynews.com.