An uptick of HIV cases among injection drug users in Massachusetts has local health officials worried about a possible outbreak, reports The Boston Globe.

By mid-December last year, 78 new HIV cases had been reported among people who inject drugs. Though that might seem small, only half as many individuals tested positive in 2016.

“It would be a little early to say we have an epidemic on our hands, but we’re primed for it,” Jenifer L. Jaeger, MD, interim medical director of the Boston Public Health Commission, told the newspaper.

Because the HIV uptick is related to the opioid epidemic, it draws comparisons to a 2015 outbreak in rural Scott County, Indiana, where the virus was introduced into a network of injection drug users and more than 180 contracted HIV within four months.

Similar to Indiana, Massachusetts is dealing with an opioid crisis, with nearly five people dying from an overdose every day. Both states also see high rates of hepatitis C virus, which can be contracted through sharing needles.

But unlike in Indiana, syringes may be legally sold and distributed in Massachusetts, which means people can access clean ones.

To curtail a possible outbreak, Massachusetts health officials have alerted doctors and are promoting ways to reduce risk.

Another challenge with regard to the situation in Massachusetts is that the new infections are occurring among younger people, who apparently don’t know about safer injection techniques.