COLUMBIA, S.C. (WBTW) – In the fall of 2018, South Carolina Department of Health and Environmental Control saw an increase in Hepatitis A cases across the state.

The sharp increase prompted the agency to declare a statewide outbreak in May. Now nine restaurants across the state have also been identified for possible exposure.

A Hepatitis A outbreak was declared in Aiken County in February 2019. Three months later a state wide declaration was made.

“We are about 10 times higher the numbers we normally see in South Carolina,” explained Dr. Jonathan Knoche with the agency’s Acute Disease Epidemiology department.

From November 2018 to May 2019 confirmed Hepatitis A cases increased from five to 48.

And there are now a total of nine restaurants where someone who was ill was working.

Dr. Knoche continued, “Only one out of 20 work in restaurants so we notify the public out of precaution to let them know they have been exposed and to possibly get the hep a vaccine.”

In the past year, 123 people have been hospitalized for Hepatitis A and there has been one death. Symptoms of the liver infection include fever, stomach pain and the yellowing of the skin.

DHEC has identified four main groups at risk.

“We usually are seeing it in certain risk groups; people who use drugs, people who experience homelessness, people who have been incarcerated and men who save sex with men,” Dr. Knoche added.

There are more than 170 cases of Hepatitis A in the state right now. However, health officials want to be very clear that 95% of the cases do not involved people working in the food industry.

Aiken County has the most reported cases at this time with 58 confirmed cases of Hepatitis A. Spartanburg County has less than five cases.