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San Bernardino County health officials Thursday declared an outbreak of hepatitis A, saying dozens of people have contracted the viral disease.

Since the start of 2019, there have been 42 confirmed hepatitis A cases in the county, according to information released by the San Bernardino County Department of Public Health. By comparison, only three cases were reported in all of 2018, the health department said.

An outbreak occurs when people in an area contract a particular disease at a rate that is “in excess of normal expectancy,” according to the World Health Organization.

Officials said clusters of the recent hepatitis cases were confirmed in the cities of Redlands and San Bernardino. People contracting the disease were predominantly in high-risk populations, such as drug users and people who are homeless, the county statement said.

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