Hepatitis A vaccine | Courtesy of the National Institute of Diabetes and Digestive and Kidney Diseases

State health officials are now recommending that everyone in a half-dozen counties, including Jefferson and Bullitt, be vaccinated against hepatitis A to curtail an outbreak that has led to hundreds of cases around the state.

The Kentucky Department for Public Health issued the recommendation Monday as the total number of cases associated with the outbreak screeched past 300 statewide. The counties with five or more cases of acute hepatitis A include Hardin, Greenup, Carter and Boyd in addition to the more local ones.

With 214 cases of the highly contagious liver infection, Louisville has been a hotbed of hepatitis A activity. Though cases have mostly been among high-risk people, namely the homeless and drug users, the outbreak has drawn concern among the general public lately because of cases popping up here and elsewhere at places like restaurants and supermarkets.

“Since we are in the midst of an outbreak, it’s certainly a good idea for everybody to get a shot,” said Dave Langdon, a spokesman for the Louisville Metro Department of Public Health and Wellness.

The state, which has had 311 cases, noted that about “30 percent of cases do not report any risk factors” for the illness, which is typically spread person-to-person when someone accidentally ingests a small bit of stool from an infected person through food or other contaminated items.

The state “recommends all children, ages 1 year through 18, receive the hepatitis A vaccine as well as adults who want to protect themselves from an acute hepatitis A infection,” Dr. Jeffrey Howard, acting public health commissioner, said in a news release. “In these counties with local transmission of the hepatitis A virus, we recommend everyone be vaccinated per guidelines to help stop this outbreak.”

The vaccine, which is “widely available” from local pharmacies and health care providers, is typically given in two doses, with initial vaccination being followed by another shot six months later, according to the state Department for Public Health. The local health department and its partners have vaccinated thousands of high-risk people to fight the outbreak.

With the Kentucky Derby fast approaching, the local department also has been urging members of the food service industry to be vigilant against the illness. That includes using good hygiene and getting employees vaccinated.

The local department and the University of Louisville Global Health Center recently teamed up to offer hepatitis A shots at a discounted price of $25 per shot to food-service and hospitality industry workers. The restaurant or business pays the fee.

“The response has been really, really good,” Langdon said.

As a further precaution, the state recommends that everyone wash their hands often, especially after using the restroom and before consuming food.