Kentucky health officials say more than 3,000 cases of hepatitis A have been reported in an outbreak that has entered its second year. Kentucky Department for Public Health statistics show 19 people have died in the outbreak. Patients have been hospitalized in more than half of the state’s 3,122 reported cases from August 2017 through the first week of December 2018. Officials in the tri counties have recommended that all residents get vaccinated against the disease. Previous vaccination efforts were targeted at people with a high risk of contracting hepatitis A, including those who use illegal drugs and the homeless. Hepatitis A attacks the liver and causes symptoms including abdominal pain, nausea, diarrhea, fever, and jaundice.