The West Virginia Bureau for Public Health (BPH) continues to investigate cases of hepatitis A as part of the multi-state outbreak that is occurring nationally. Persons who use injection and non-injection drugs, persons with unstable housing or are homeless, persons with recent history of incarceration, and men who have sex with men (MSM) are at considerable risk for infection. There is continued transmission of hepatitis A in West Virginia due to increasing case counts and the long incubation period of the disease.