FRANKFORT, Ky. (AP) — Kentucky health officials say they are seeing a dramatic rise in hepatitis A cases compared to recent years.

The Kentucky Department for Public Health has identified hepatitis A with cases in multiple counties in Kentucky.

The office says 31 cases of acute hepatitis A have been reported this year. It’s a 50 percent increase over the average of 20 cases per year reported over the past 10 years. The acute cases mean the patients are showing signs of illness.

Jefferson County has had 19 confirmed cases. No deaths have been attributed to the outbreak.

The disease has also been reported in Shelby, Bullitt, Hardin, Henry, Anderson, Mason, Christian, Madison, Fayette, McCracken, Hopkins, and Leslie counties.