CLEVELAND -- The Cuyahoga County Board of Health warns of a spike in Hepatitis A cases reported this year.
The board says there have been 13 confirmed cases in Cuyahoga County in 2018. On average, there are four reported cases per year.
Four cases reported in September have been linked to a multi-state Hepatitis A outbreak connected to Indiana, Michigan, Kentucky and West Virginia.
The board says it's waiting on additional information regarding three cases reported in October to determine if they are related to the same outbreak.
Hepatitis A is a liver disease typically spread by ingesting fecal matter or close contact with an infected individual.