West Virginia health officials say 540 confirmed cases of hepatitis A have been reported in the state.

The Herald-Dispatch reports the Department of Health and Human Resources said 297 of the cases are in Kanawha County. The totals are from Friday.

In Cabell County, the number of cases rose 21 percent this week to 114, up from 94 the previous week.

The cases have been linked to the virus strain found in a multistate outbreak.

The Centers for Disease Control and Prevention says hepatitis A is a communicable disease of the liver caused by a virus. It is usually transmitted person-to-person or by consuming contaminated food or water.

Unrelated, McDonald's is stopping the sale of salads at 3,000 restaurants after people became sick from a parasite causing intestinal illness.

The Chicago-based fast-food chain said Friday it's acting "out of an abundance of caution" until switching to another supplier.

Health officials in Illinois and Iowa say they've identified roughly 100 combined cases of cyclosporiasis apparently linked to consuming McDonald's salads. The illness is caused by the Cyclospora parasite.

Also, Kelloggs is recalling Honey Smacks cereal with salmonella.

Salmonella is usually associated with eggs, meat, and poultry, but health experts say bacteria can live in nearly any food.

As of Thursday, there have been no deaths from the Honey Smacks outbreak, but 73 people in 31 states have been sickened. In our region, there has been one report in Ohio, three in West Virginia, and one in Kentucky.

Dr. Thomas Rushton, a specialist in infectious diseases at St. Mary's Medical Center, says the symptoms don't occur quickly.

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