SPRINGFIELD, Ill. (AP) – The Illinois Department of Public Health is encouraging those at greatest risk of contracting hepatitis A to get vaccinated against it after five cases were confirmed in east-central Illinois during November.

Department Director Dr. Nirav Shah says the recent cases serve as a reminder that states bordering Illinois have been seeing hepatitis A outbreaks.

Those at highest risk for infection included men who have sex with men, homeless people and drug users. The department says those people should check with their local health department about free or reduced-cost vaccine.

Hepatitis A is an infection that can damage the liver. It is spread easily through food, water, drug use, and sex. Symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, joint pain, jaundice, dark urine, and clay-colored bowel movements.