The HIV outbreak in southeastern Indiana has acquired two dozen new cases in the past week, health officials said Friday, and the area now has a total of 130 cases in the largest outbreak it has ever seen, the Louisville Courier-Journal reported. Of those, 120 cases are confirmed and 10 were considered "preliminary" positives.

The virus has been spreading primarily among intravenous drug users of an opioid painkiller called Opana, health officials said. To get high, users grind up the painkiller, mix it with water and inject it.

The HIV cases are occurring in Scott County. The county usually has only five new HIV cases annually, but by March of this year had 79 confirmed cases, which the Indiana Health Department qualified as an epidemic.

"This sharp increase in the number of HIV-positive cases demonstrates just how critical it is that we are able to locate and test people who have been exposed so that they can avoid spreading it to others and get medical treatment," Dr. Jerome Adams, Indiana's state health commissioner, said, the Courier-Journal reported.

In March, Indiana Gov. Mike Pence declared a public health emergency and gave an executive order to create a needle-exchange program -- otherwise illegal -- to halt the spread of the virus. So far 86 people have obtained 5,322 clean needles through the program, the Associated Press reported.

Pence also created a command center to oversee HIV and drug abuse treatment and started a public awareness campaign about how to prevent HIV transmission. But the outbreak has worried public health officials not just in Indiana but also throughout the United States as they face rising rates of prescription drug abuse, including by injection. 

In Austin, a town in Scott County, intravenous drug use has been rising for years, with some doctors fearing that addicts will scoop up just about any needle, used or not, in order to get a fix. These practices contribute to the spread of HIV and also other blood-borne diseases, like hepatits C.

William Cooke, a doctor in Austin, told the Washington Post after the HIV outbreak began, "We saw this coming a long time ago." He added, "There's a lot of poverty and very few resources available to the community. We've been asking for help for some time."