Boise (670 KBOI News) – Since when is six cases of a disease in two months considered an outbreak? When there are usually two cases a year.

The Central District Health Department is reporting an outbreak of Hepatitis A in Ada and Elmore Counties, due to six cases being reported since January first.

All six cases have been 30 to 60 year old men, and the disease appears to be spread locally.

The disease spreads typically among IV drug users and homeless populations. It can also be spread by fecal-to-oral transmission, or passed along in food that has been handled by an infected person.

In Sal Lake County Utah, there have been 295 cases reported in the last two years.

Symptoms include nausea, jaundice, lack of appetite, fever, and abdominal pain.