The Board of Supervisors Tuesday extended a state of emergency over the hepatitis A outbreak in San Diego County, despite a decline in the number of new cases and no new deaths in the last two weeks.

Health officials told the supervisors that the drop in case numbers is a sign that efforts to fight the outbreak are working. They stressed the need for the county to continue vaccination, prevention and educational efforts that have been in place since the emergency was declared in September.

There have been two additional confirmed cases since data was released last week, brining the total number of cases to 546 in the nearly year-old outbreak. Twenty people have died, according to Dr. Wilma Wooten, the county's public health officer.

Special Coverage: San Diego's Hepatitis A Outbreak

There are still 32 suspected cases pending confirmation by the U.S. Centers for Disease Control and Prevention.

Last week saw the lowest number of cases reported in the county since March, according to Dr. Eric McDonald, deputy public health officer.

RELATED: City Council To Consider Plans To Fund Large Tents To Temporarily House Homeless

"It appears we are past the peak of cases and things are improving," he said.

In the San Diego region, nearly two-thirds of the victims have been either homeless, users of illicit drugs or both. Much of the county's efforts have focused on those populations. McDonald said its important that the county continue its efforts to prevent the outbreak from spreading to other groups. He said there could be a second peak if the outbreak were to affect men who have sex with men, for example. The county is also targeting vaccination efforts to the LGBT community.

More than $5.5 million has been spent by the county to fight the spread of the disease, including administering over 100,000 vaccinations and spreading awareness among the public, according to county documents.

RELATED: Councilman Wants To Use San Diego’s Hotel Room Taxes To Fund Permanent Homeless Housing

Hepatitis A is usually transmitted by touching objects or eating food that someone with the virus has handled or by having sex with an infected person. The disease does not always cause symptoms, but for those who do, they could experience fever, fatigue, nausea, loss of appetite, yellowing of the eyes, stomach pain, vomiting, dark urine, pale stools and diarrhea, according to the HHSA.

The county and city of San Diego have taken several steps to address the outbreak, including the spraying of a sanitizing formula on streets and sidewalks, the placement of portable hand-washing stations and restrooms in areas where the homeless congregate, and the stepped-up immunization campaign.

"We must remain vigilant and continue our vaccination, sanitation and education efforts," Wooten said. "These combined efforts ... are indeed paying off."

FEATURED PODCAST KPBS' daily news podcast covering local politics, education, health, environment, the border and more. New episodes are ready weekday mornings so you can listen on your morning commute.





Sign up for Today's Top Stories newsletter Need help keeping up with the news that matters most? Get the day's top news — ranging from local to international — straight to your inbox each weekday morning. Enter your email address

To view PDF documents, Download Acrobat Reader.