The hepatitis A outbreak in Yakima County has grown to 11 confirmed cases, the Yakima Health District said Thursday.

In a news release announcing six additional cases, the health district said everyone diagnosed is either homeless or using illicit drugs.

The health district first announced an outbreak Nov. 7, when five cases were diagnosed in Yakima County. Since then, local health care providers have vaccinated 74 people.

The health district has been reaching out to affected communities to provide information about symptoms and preventing exposure.

Yakima Neighborhood Health has seen an increase in people — including the homeless — seeking vaccinations since the outbreak was announced, said spokeswoman Leah Ward.

“Staff hasn’t counted the numbers but said it’s been a noticeable increase,” she said. “Also, we have sent staff out to Camp Hope to vaccinate people there.”

Camp Hope is a homeless encampment behind the former Kmart where more than 100 men, women and children are living in military tents.

Pharmacy students from Washington State University visited Yakima in early November to administer vaccinations at a Safeway store.

When the outbreak first emerged in Yakima, the Health District warned that customers of the Popeye’s Louisiana Kitchen restaurant in Yakima could have been exposed.

The restaurant was disinfected to assure no risk to staff and customers.

But the restaurant wasn’t a source of the outbreak, said Lilian Bravo, director of public health partnerships for the Yakima Health District.

“It was an isolated incident,” she said.

The flare-up here has been traced to an outbreak in Spokane, which was connected to one in Michigan, she said.

“The outbreak in general is a trend we’re seeing statewide and nationally,” Bravo said. “They all are very much related.”

Hepatitis A is highly contagious liver disease, according to the Centers for Disease Control and Prevention. Mild infections last a few weeks, but severe cases can linger for several months — and, in rare instances, hepatitis A can be fatal.

The virus is contracted from contact with objects, food or drinks contaminated by feces or stool from an infected person.

Symptoms include fever, joint pain, yellowing of the skin and eyes and take two to six weeks to develop after infection. Hepatitis A can be prevented by a vaccine.

The state Department of Health declared a statewide hepatitis A outbreak in July. Through Nov. 21, the department reported 124 total cases throughout the state, 66 hospitalizations and two deaths.

More information can be obtained from the Yakima Health District, the state Department of Health, and the CDC.

Reach Phil Ferolito at pferolito@yakimaherald.com or on Twitter: @philipferolito