The Florida Department of Health has issued an advisory expressing concern about a significant increase in hepatitis A cases in Florida and across the country.The advisory, announced Thursday by State Surgeon General and State Health Officer Dr. Celeste Philip, mentions the Tampa Bay and Orlando areas as hot spots for the virus.It also stresses the importance of vaccination against hepatitis A, which spreads person-to-person through feces contaminated with the virus.Pinellas and Hillsborough counties have seen a handful of high-profile cases recently. Two workers at a pair of restaurants in the region were found to have the virus, prompting one restaurant to close permanently and causing the other to be placed under investigation. The cases are among a growing number of infections nationally, and part of the largest outbreak since the hepatitis A vaccine was developed nearly 20 years ago.Since January, there have been 385 cases of hepatitis A reported in Florida, according to the health department. That’s more than three times the previous five-year average of 126 cases.Florida's case load is beginning to mirror national trends, health officials say. Other health departments across the country have been working with the Centers For Disease Control and Prevention since March 2017 to ward off outbreaks.PREVIOUS COVERAGE: Why are we suddenly hearing about hepatitis A outbreaks? Experts blame the opioid crisis.Generally, fewer than 3,000 cases of hepatitis A are reported nationwide each year, according to the CDC. But that hasn’t been the case recently. More than 7,000 cases have been reported from 12 states this year.The most notable outbreak happened in San Diego, Calif., and spread to the Los Angeles, Monterey and Santa Cruz areas. The state has been battling a rise for years, but in 2017 California Gov. Jerry Brown declared a state of emergency when there were more than 700 active cases of hepatitis A with more than half of those patients needing to be hospitalized. Twenty-one people have died from the outbreak.Getting it under control was expensive — California bleached the streets in San Diego, set up mobile vaccination units and hosted hundreds of vaccination events, opening dozens of public hand-washing stations.In the Tampa Bay area last month, the owners of a Hamburger Mary’s franchise in Ybor City closed the restaurant temporarily then announced it would not reopen after a worker there tested positive for hepatitis A. Also in November, the Toasted Monkey Beach Bar & Grille on St. Pete Beach temporarily closed when one of its workers tested positive for the virus.Public health experts say the majority of the cases come from white men in their young adult years to middle age. Most are from transient populations with limited access to sanitation methods and are more commonly drug users.The Florida Department of Health will be reaching out with vaccinations to communities that are most at risk for the illness: people who report drug use, homeless populations and gay men. In addition, the department will be working with local jails, drug treatment centers, homeless shelters and hospitals to educate and vaccinate.Florida health officials say hepatitis A is vaccine-preventable illness. Practicing proper hygiene, like washing hands thoroughly before preparing or eating food, is another way to ward against the virus.Hepatitis A symptoms include fever, dark urine, yellow-tinged skin or eyes, fatigue and gastric issues. It can also cause damage to the liver, especially among those who already have liver disease.Contact Justine Griffin at [email protected] or (727) 893-8467. Follow @SunBizGriffin.