Health officials in Florida have issued a hepatitis A advisory after a spike in cases in the Orlando and Tampa areas. A statement from the Florida Department of Health urged people, especially those considered at risk, to get vaccinated. “Since January 2018, 385 cases of hepatitis A virus (HAV) infection have been reported in Florida. This is more than three times the previous five-year average of 126 cases. The increase in hepatitis A cases to date is predominantly in the Tampa Bay and Orlando metropolitan areas,” the advisory said. In October, Orange County health officials reported a 2,000 percent increase in cases in 2018. Hepatitis A is a viral illness that affects the liver and is typically spread person to person through fecal-oral transmission.Symptoms include fever, abdominal pain, loss of appetite, nausea, vomiting, jaundice or yellowing of skin and eyes and dark urine.The hepatitis A vaccine is a two-shot series with the second one given after six months.Health officials recommend that the following people be vaccinated: • All children at age 1 year• Persons who are at increased risk for infection• Persons who are at increased risk for complications from HAV• Users of injection and non-injection drugs• Persons who are homeless• Men who have sex with men• Persons who have chronic liver disease• Persons traveling to or working in countries that have high or intermediate endemicityof HAV• Persons who have clotting-factor disorders• Household members and other close personal contacts of adopted children newlyarriving from countries with high or intermediate HAV endemicity• Persons having direct contact with persons who have HAV.