MINNEAPOLIS (WCCO) – A different sickness is ailing some Minnesotans this flu season.

The Department of Health says that 49 cases of Hepatitis A have been identified in the state, leading to 35 hospitalizations.

Hepatitis A is a liver disease than can lead to death. It’s spread by shared syringes, eating and drinking, unwashed hands, and sex.

Symptoms include yellow skin and eyes, dark urine, vomiting and diarrhea, or abdominal pain.

The best way to avoid the infection is to get a vaccination.

Hennepin County has been affected the most, with 16 cases. Kanabec County and Pine County have each had five cases, while St. Louis county has four.

Outbreaks of the infection have been popping up in several states across the country since 2016.

Health officials say the people at highest risk include those who use drugs, experience homelessness, have been recently incarcerated, or those in homosexual relationships.