Updated

California is expected to place an order for more hepatitis A vaccines after Gov. Jerry Brown declared a state of emergency on Friday to combat the deadly outbreak. Brown said the action will allow the state to purchase vaccines directly from manufacturers, with the first orders planned for Monday or Tuesday.

The state is in the midst of the largest person-to-person hepatitis A outbreak in the United States since the vaccine was introduced, with at least 576 confirmed cases and at least 18 deaths. The outbreak includes cases recorded in San Diego County, Santa Cruz County and Los Angeles County. The homeless population is among the hardest hit.

Health officials have distributed 81,000 federally-funded vaccine doses since the outbreak began, but the state’s epidemiologist with the California Department of Public Health said the supply is insufficient.

PARAMEDICS AUTHORIZED TO GIVE VACCINES AMID SAN DIEGO HEPATITIS A OUTBREAK

“We have the capacity to use as much vaccine as we can get our hands on,” Dr. Gil Chavez told the LA Times.

Earlier this month San Diego granted paramedics the authority to administer vaccines to the area’s at-risk populations. The measure allows for paramedics to deliver necessary doses under the supervision of nurses and at vaccination events.

While many cases of hepatitis A stem from contaminated foods, the current outbreak focuses on person-to-person transmission. People without symptoms can carry the illness, and is spread through contact with an infected person’s feces. The virus can spread through food, objects, sex or sharing drug paraphilia. San Diego implemented power-washing streets and installed hand-washing stations, with plans to open an encampment for the homeless equipped with tents, showers, restrooms, food security and social services.

Medical experts warned the outbreak could last for more than a year.

The Associated Press contribute to this report.