LOUISVILLE, Ky. (WDRB) -- With the hepatitis A outbreak still spreading, health officials are urging the thousands of people coming downtown for Saturday's Thunder Over Louisville air show and fireworks to be extra vigilant.

As of April 20, there were 352 confirmed hepatitis A cases in six Kentucky counties. Three people have died after contracting the virus. 

Here's how the numbers break down: 

  • Jefferson County: 244
  • Boyd County: 31
  • Bullitt County: 17
  • Greenup County: 16
  • Hardin County: 7
  • Carter County: 6

The state health department said everyone in the six hardest-hit counties over the age of one should get the vaccination.

In Indiana, there were 66 confirmed cases as of April 20, including 30 in Clark County and 19 in Floyd County.

The virus is spread primarily by ingesting human waste, and the best way to prevent it is by washing your hands before you eat or drink.

For Thunder Over Louisville, Metro Health and Wellness is tripling the number of hand-washing stations and urging food vendors to have all their employees vaccinated.

"Every year, our environmental team inspects the different vendors at those festivities." Dr. Lori Caloia said. "Each and every vendor, we look at their food safety and food handling practices and make sure that those are up to par."

She said anyone not in compliance will be shut down.

"We also are going to be posting a lot of signage this year at the festivities, just reminding people to wash their hands," Caloia said. 

The vaccine for the virus is given in two doses: the initial shot and then a follow-up six months later.

If you have insurance, there should be no out-of-pocket cost.

Related Stories:

Copyright 2018 WDRB Media. All rights reserved.