A health department spokesman in West Virginia says more than 20 cases of acute Hepatitis A have been confirmed in Kanawha and Putnam counties since January.
The Kanawha-Charleston Health Department says in a news release that the recent cases are linked to a multistate outbreak.
Prior to January, the department said no confirmed cases had been reported in more than two years.
The Kentucky Department for Public Health says 311 cases had been reported in six counties, including one death. Among other states that have seen recent outbreak are California, Indiana, Michigan and Utah.
Hepatitis A is transmitted by oral contact with fecal matter. It attacks the liver and causes symptoms including abdominal pain, nausea, diarrhea, fever and jaundice.