September 13, 2017 2:24 PM EDT

An outbreak of Hepatitis A in San Diego County has now taken 16 lives, local health officials said, with 421 total cases and 292 hospitalizations.

A local public health emergency was declared in the county on Sept. 1, the Los Angeles Times reports, and city and county officials have taken steps to counteract the spread of the virus. A vaccination campaign is underway, and since the virus is spread by contact, officials have urged diligent hand-washing. They have also sprayed down sidewalks in the city and opened tents with showers, bathrooms and hand-washing stations that can serve as temporary shelters so hundreds of homeless people can leave the sidewalks where infections have been spread, the Times reports.

Symptoms of Hepatitis A (which not everyone who is infected will experience) include fever, jaundice, fatigue, nausea and digestive issues. Although most people recover on their own or with light treatment, it can be fatal for those with preexisting conditions and liver damage.

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