Outbreaks of hepatitis A among the homeless populations in San Diego and Santa Cruz counties prompted an alert by Los Angeles County health officials Monday to urge physicians and health care workers to look for and report any confirmed cases.

The alert was issued because the disease has the potential to spread to Los Angeles County, health officials warned.

The outbreaks in San Diego and Santa Cruz counties are among homeless people who may or may not be using drugs and is being spread “person-to-person through close contact or through contact with a fecally contaminated environment,” according to the alert.

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It’s also being found among people who provide services to the homeless population in those counties.

A similar alert was issued by public health officials in Orange County, where one resident developed hepatitis after spending time in San Diego. The man had a history of homelessness.

Los Angeles County health officials identified two confirmed cases of hepatitis A in local homeless patients who lived in San Diego during their exposure period, according to the alert. Two other people were identified in a health facility.

Health officials said the best way to prevent an outbreak in Los Angeles County is to vaccinate those who are homeless and/or who use illicit drugs.

Hepatitis A is a liver disease whose symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and a yellowing of the skin or eyes or jaundice.

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As of last week, there were 275 cases reported and eight deaths in San Diego County. In Santa Cruz County, 38 cases have been confirmed.

“These cases and the proximity of Los Angeles County and San Diego highlight the possibility that additional cases may be introduced into Los Angeles County in the future and could result in an outbreak,” health officials said in the alert. “It is unknown how long the outbreaks in San Diego and Santa Cruz counties will continue.”

Health officials are urging physicians and health care workers to report cases to Los Angeles County Morbidity Unit by faxing a Confidential Morbidity Report (CMR) to 888-397-3778 or by calling 888-397-3993.