LEXINGTON (AP) — Health officials say hepatitis A is continuing to spread around Kentucky.

WKYT-TV cited the Kentucky Department for Public Health in reporting that there were 1,094 cases and eight deaths from the outbreak as of the first week of July. The agency says 18 counties reported new cases during that week.

Jefferson County, where Kentucky’s outbreak began last fall, has the most cases with 525 reported. Most than half of Kentucky’s 120 counties have reported at least one case.

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.