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NAPLES, Italy — U.S. Navy officials are warning shoppers not to buy shellfish from street vendors or door-to-door sellers after Italian officials linked cases of Hepatitis A in the Caserta province to the unregulated vendors.

"We’re advising people against buying fish, especially shellfish, from street vendors, who don’t always maintain temperature control, and the fish are just sitting in water and water can carry the virus," said Lt. Sherry Hayes, head of the preventative medicine office at U.S. Navy Hospital in Naples. "And you don’t know where the shellfish came from."

Navy officials distributed an e-mail Thursday evening to military members and U.S. civilians about the problem.

Hepatitis A is an acute liver disease, an inflammation of the liver, caused by the Hepatitis A virus, lasting from a few weeks to several months, according to the Centers for Disease Control and Prevention. It does not lead to chronic infection. It is transmitted by ingestion of fecal matter, even in microscopic amounts, from close person-to-person contact or ingestion of contaminated food or drinks.

There is a vaccine and all active-duty military personnel are required to undergo the two-shot series, Hayes said. Dependents traveling to Europe strongly are encouraged to be vaccinated. Those who aren’t can get vaccinated at the hospital, she said.

Two Italian health department officials in Caserta said Friday the number of cases of Hepatitis A has risen by two or three in recent months. "There is no cause for alarm," said one official with Caserta’s health department, who declined to provide his full name because he is not authorized to speak to the media.

The U.S. Navy hospital reported one case of Hepatitis A in the past four months, Hayes said. Physicians are unable to trace the source of the one case, she said.

One reason it is difficult for health officials to trace the source of an outbreak is the long incubation period of the virus, which can manifest symptoms any where from 15 to 50 days after exposure, Hayes said. "It’s hard to remember what you might have eaten two months ago."

Symptoms can include the abrupt onset of fever, malaise, nausea or abdominal pains, followed by jaundice, or a yellowing of the skin and eyes. Since it’s a virus, it cannot be treated with antibiotics, so physicians treat the symptoms, she said.

Hepatitis A can also be ingested from contaminated fruits and vegetables, so officials recommend cleansing them thoroughly. And fish, whether bought from a grocery store or street vendor, should be thoroughly cooked to avoid becoming ill, she said.

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