A fifth person has died in San Diego County’s ongoing hepatitis A outbreak — the state’s largest in two decades, public-health officials said Wednesday.

The outbreak started in November 2016 and has grown among the region’s homeless population. There have been 228 confirmed infections, including 161 people who had to be hospitalized, according to the county’s Health and Human Services Agency.

The virus that causes the disease moves from person to person through shared food, drink, drugs or other forms of close contact. Health investigators have not discovered the source of the outbreak, though they note that poor sanitation — not washing hands after using the bathroom, for instance — is the most likely culprit. If left untreated, hepatitis A attacks the liver and can lead to death.

According to the county agency’s latest update on the outbreak, about 70 percent of the confirmed cases have involved homeless people. It has not said whether the same pattern applies to the five fatalities, and it has declined to make public the ages and genders of those five victims.


Hepatitis A can be prevented through vaccination, and that has been the agency’s main strategy for stopping the outbreak.

Free, county-run vaccination clinics have been offered since the spring at certain nonprofit groups’ facilities where the homeless often receive services. In recent weeks, public-health nurses have expanded their participation in vaccination “foot teams,” visiting people living everywhere from city streets to public parks.

County officials have indicated that they will pursue installation of hand-washing stations and distribution of sanitation kits for the homeless. A county official said Wednesday afternoon that hygiene kits have been distributed to local homeless outreach organizations and that a single hand-washing station would be installed in San Diego’s Fort Rosecrans-Midway district this weekend.


Public-health experts said in addition to getting vaccinated, people should wash their hands for at least 20 seconds with soap and running water before eating and after using the bathroom. People are also advised to avoid directly touching bathroom door handles when exiting a public restroom and avoiding shared food, beverages or smoking materials.

Related links:

What is causing San Diego’s hepatitis A outbreak?

Hepatitis A kills fourth county resident

Pomegranate seeds linked to hepatitis A infections


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paul.sisson@sduniontribune.com

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