Cases of hepatitis A—some of them fatal—continue to spread across the country, confounding local and federal health officials. Fourteen states (Arizona, California, Hawaii, Idaho, Indiana, Kentucky, Maryland, Michigan, New York, Rhode Island, Utah, Washington, West Virginia, and Wisconsin) are the latest to report higher-than-average hep A activity. At least 1,200 cases have been reported nationwide since March 2017, when the Centers for Disease Control and Prevention declared the outbreak; 40 of those patients died as a result. Some, but not all, genotypes are common among multiple states. Urgent care providers are urged to assure patients who ask that hepatitis A is most commonly spread by consuming contaminated food or drink, and not by sneezing or coughing, and to report cases of hep A to their local health department. One puzzlement for health officials is that cases are cropping up in patients who are neither homeless nor substance abusers (or their close contacts)—all of whom might be typically viewed as most at risk. One clue is that more cases than normal have been seen among foodservice workers in the outbreak states.