The Salt Lake County Health Department announced Tuesday that two county residents have died in Utah’s ongoing hepatitis A outbreak.

The first person died in January but had other health conditions and officials were waiting on tests to declare an official cause of death. The second person died in late March.

Both were adults who belonged to one or more population groups previously identified by health officials as high-risk for contracting Hepatitis A. Those groups include people who are homeless, substance abusers, and people who are or have recently been incarcerated. Because of medical privacy laws, public health officials aren’t sharing additional specifics about the two people who died.

The strain of hepatitis A implicated in the deaths matches the strain that is associated with a multistate outbreak that has hit California and Michigan particularly hard. A handful of other states also have confirmed cases of infection from the outbreak strain. Nationwide the outbreak has sickened more than 1,200 and killed more than 40.

“These deaths are a tragic reminder that Hepatitis A is a serious disease — but one that is preventable,” said Dr. Dagmar Vitek, medical director for the county Health Department. “Vaccination is the best way to prevent infection, and the vaccine is widely available from health care providers, pharmacies, and Salt Lake County immunization clinics.”

Hepatitis A vaccine is given via two shots at least six months apart. The U.S. Centers for Disease Control and Prevention says the first dose provides 94 percent protection against Hepatitis A for two to five years and the second 99 percent protection for 20 to 25 years. Vaccine appointments are available at Salt Lake County immunization clinics by calling 385-468-7468.

People can also dramatically reduce their risk of contracting Hepatitis A by washing their hands frequently and thoroughly, especially after using the restroom, changing diapers, and eating, serving or preparing food.

“Food handlers must be especially vigilant about hand washing, and we encourage restaurant workers to consider receiving the vaccine to protect both themselves and their customers,” Vitek said in a county Health Department release issued Tuesday.

Through April 2, Salt Lake County has identified 148 cases of Hepatitis A related to the outbreak; the state as a whole has had 212 cases to date, the Health Department said. About half of those cases have resulted in hospitalization, the Salt Lake Tribune reported.

Epidemiologists have linked the Utah outbreak, which began in summer 2017, to a national outbreak first reported in San Diego, California.

Since August 2017, the Salt Lake County Health Department has conducted targeted vaccination and awareness campaigns to try to control the outbreak, including holding on-site vaccination clinics at places where individuals thought to be at high risk congregate. The department has also distributed thousands of hygiene kits to people in need; the kits contain soap, disinfectant wipes and other products encouraging hand washing and good hygiene.

Hepatitis A is a contagious liver disease that, unlike other forms of hepatitis, does not usually result in chronic infection. It is caused by a virus and can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. Hepatitis A is usually spread when a person ingests the virus from contact with objects, food or drinks contaminated by feces from an infected person. Symptoms include fatigue, nausea, abdominal pain, diarrhea and jaundice (yellowing of the skin and eyes).

The infection can be more serious for people whose immune systems are compromised because of chemotherapy or other causes.