What to Know Anyone who may have been exposed to the virus can develop symptoms up to 50 days after the exposure.

The disease can be spread through sexual contact, as well as touching objects or eating food contaminated with the virus.

County officials say the best way to prevent hepatitis A is to get vaccinated.

Fourteen lives were claimed in the ongoing Hepatitis A outbreak in San Diego County, with county health officers issuing new vaccine recommendations.

People who handle food should now get a vaccination for Hepatitis A, recommended the County's public health officer.

There have been 352 total cases of the virus and 264 people have been hospitalized since the outbreak. The viral liver disease can cause liver failure and death.

“This is a proactive recommendation because the ongoing outbreak means that the risk to the general public is higher than normal,” said Wilma Wooten, M.D., M.P.H., county public health officer, in a statement.



There is concern that anyone handling food could expose more members of the public to the disease, said county officials.

“A person who becomes infected with Hepatitis A may spread the disease to others before experiencing symptoms. In an occupation such as handling food, workers may expose more members of the public than workers in other occupations," added Wooten.

Food handlers could get the vaccination from their occupational health provider, health care provider or a local pharmacy, said county health officials. They do not need a prescription to get the vaccine.

If insurance is an issue, food handlers can also get the vaccine for free at all County public health centers. This only applies to uninsured or under-insured individuals. For a list of locations that offer the vaccine, call 2-1-1 or visit sdiz.org.

Those who work in health care should also get the vaccine, along with workers in public safety, sanitation, homeless shelters and behavioral and homeless service providers, said county officials.

Homeless people and drug users account for about 70 percent of the illnesses, said county officials. One in five people diagnosed with Hepatitis A also has Hepatitis C.

County officials said they are increasing efforts to ensure the homeless have access to vaccines, as well as those who come in contact with them. Teams of public health nurses go into the community on "foot teams" to offer homeless people vaccinations.

High-risk groups for the virus include travelers to certain countries, drug users, homeless people, people with chronic liver disease, people who work at homeless services agencies, health care personnel and people involved in sanitizing areas where the homeless are located.

Visit San Diego County's HHSA to learn more about San Diego's immunization program.

Good hygiene can also help to prevent Hepatitis A. County officials recommend washing your hands for 20 seconds with soap and water before eating, after using the restroom or changing a diaper.

They also advise against directly touching the door handle when exiting a public restroom, as well as sharing food, drinks or smoking materials with other people.

General information on Hepatitis A is available on the HHSA hepatitis website with regular updates, and a county fact sheet is available here.