Hepatitis A infections have killed three more San Diego County residents, according to a new public health report, pushing the fatality total to 14 for a long-running outbreak which has hit the region’s homeless population especially hard

The latest set of numbers released by the county Health and Human Services Agency shows that, despite widespread vaccination and outreach efforts, the current surge of deadly sickness is far from over.

In the last week, the county has confirmed 19 new cases and 32 new hospitalizations, pushing totals since late November 2016 to 352 and 264 respectively. Both numbers eclipse every single-state hepatitis outbreak listed in the U.S. Center for Disease Control and Prevention’s foodborne illness-tracking database since 1998.

From 2012 to 2016 county records show that the county averaged only 28 acute hepatitis A cases per year.


San Diego’s hepatitis outbreak has recently grown more deadly. County information updates show that there were only four deaths from late last year through June 27 of this year. By comparison, 10 deaths have been reported in July and August alone.

While the death rate appears to have accelerated this summer, that does not necessarily mean that the caseload or number of hospitalizations is slowing down significantly.

According to county reports, there were 53 new cases and 40 new hospitalizations reported in May compared to 77 new cases and 70 new hospitalizations reported in August.

The county’s efforts to get the outbreak under control started with widespread vaccination efforts. In addition to existing vaccination clinics, inoculation services have been offered through nonprofit organizations that work with the region’s growing homeless population. As the number of cases continued to mount, the health department started sending out foot teams to deliver vaccinations, and advice on how to keep clean, in locations where those without homes are known to congregate.


Dr. Wilma Wooten, the county’s public health officer, said her department has administered more than 15,000 hepatitis A vaccination doses so far this year. The county also tested a hand-washing station in the city’s Midway district. Two more stations, Wooten said last week, would soon be added at popular hang out locations in downtown San Diego and El Cajon.

Efforts have also been underway this summer to make sure that the myriad organizations who feed the homeless are using proper food-preparation techniques known to reduce the chance of contamination. So far, Wooten said last week, there have been no cases detected where food preparation was improper.

With so many living on the street, some have noted that there are simply not enough bathroom facilities available. A recent Voice of San Diego report noted that a bathroom near a major East Village homeless encampment which is supposed to be open to the public had been kept locked. A city official told the publication that a sign will be posted to let homeless residents know that they can request a key for the bathroom from a nearby restaurant.

The disease is most commonly passed through shared food, drink, drugs contaminated when an infected person fails to wash his or her hands after using the bathroom. In rare cases hepatitis A can cause deadly liver damage.


Symptoms include diarrhea, nausea, vomiting, fatigue, fever, loss of appetite, dark urine, itching, weight loss and yellow skin and eyes.

More recently, Santa Cruz County has reported an increase in the number of hepatitis A cases popping up among its homeless residents. Michigan has also seen a significant and ongoing outbreak near Detroit with 190 confirmed cases and 10 deaths occurring from Aug. 1, 2016, through June 26, according to a recent media account.


Health Playlist On Now Video: Why aren't Americans getting flu shots? 0:37 On Now Video: Leaders urge public to help extinguish hepatitis outbreak On Now San Diego starts cleansing sidewalks, streets to combat hepatitis A On Now Video: Scripps to shutter its hospice service On Now Video: Scripps La Jolla hospitals nab top local spot in annual hospital rankings On Now Video: Does a parent's Alzheimer's doom their children? On Now Video: Vaccine can prevent human papillomavirus, which can cause cancer 0:31 On Now 23 local doctors have already faced state discipline in 2017 0:48 On Now EpiPen recall expands On Now Kids can add years to your life

paul.sisson@sduniontribune.com

(619) 293-1850


Twitter: @paulsisson