LAS VEGAS (AP) - Health officials in Las Vegas are using the word “outbreak” to describe a sharp spike in hepatitis A cases reported mostly among homeless people and drug users.

The Southern Nevada Health District reported Wednesday that from November to June it tallied 83 cases of the virus that causes liver damage and can lead to death.

That’s far more than the 58 cases reported in 2016, 2017 and 2018, combined.

The district says more than 80% of reported patients were people without a permanent place to live and 92% use drugs, whether intravenous or not.

The district has begun posting weekly outbreak updates on its website at www.SNHD.info/hep-a-control .

Clinical services chief Dr. Fermin Leguen, told the Las Vegas Review-Journal recently that the numbers are alarming. He noted that cases are being reported nationwide.

Public health emergencies have been declared in cities including Miami and Philadelphia, and the Centers for Disease Control and Prevention is tracking outbreaks in 27 states.

An outbreak of hepatitis A among homeless people in San Diego killed 20 in 2017.

Clark County officials announced in July that during a two-day count in January, almost 5,300 people were tallied living on sidewalks, vacant lots, parks and drainage tunnels in and around Las Vegas. That was down from about 6,100 in 2017.

The Southern Nevada Health District said the trend in hepatitis A cases has been upward: six reported cases in 2016; 13 cases in 2017; and 39 in 2018.

The Review-Journal accompanied a crisis intervention team visiting hepatitis A “hot spots” in Las Vegas to offer vaccine shots.

The vaccine for the hepatitis A virus is effective soon after inoculation, although a second dose is required after six months for full coverage.

Fuilala Riley, president of Help of Southern Nevada, told the newspaper that access to running water for people to wash their hands is important in preventing spread of the virus.

Hepatitis A is most often transmitted through consumption of water or food contaminated with feces.

Symptoms can include fever, fatigue, vomiting, abdominal pain, dark urine, nausea and jaundice - a condition sometimes associated with liver disease that turns the skin and whites of the eyes yellow.

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