NASHVILLE (AP) — Tennessee health officials say at least 74 people have contracted hepatitis A in Nashville since last December.

Nashville's Metro Public Health Department said in a statement on Friday that it continues to work with state and local officials to urge people to get vaccinated in an effort to end the outbreak. The statement says free vaccines for at-risk groups are being offer at three public health centers. Health officials say at-risk groups include drug users, homeless people or men who have sexual contact with other men.

Hepatitis A is a liver disease caused by a virus but it can spread through close contact with an infected person. Symptoms include fever, nausea, vomiting, abdominal pain and dark urine.

Other states, including Kentucky and West Virginia, have also reported outbreaks.