San Diego County reports the fourth death in continued hepatitis A outbreak

Tom Christensen

County of San Diego Communications Office

A fourth person has died as a result of the hepatitis A outbreak in San Diego County that now totals 160 cases, the county Health and Human Services Agency announced.

One hundred and twenty people have been hospitalized during the outbreak. Public health investigators are continuing to evaluate cases, but thus far no common food, drink or drug source has been identified as the cause. Most of those who have become ill are either homeless or using illicit drugs.

The county has been working with community partners to conduct vaccination clinics for people who are at risk for hepatitis A. These partners include homeless services providers, community health clinics, faith-based community organizations, substance use treatment providers, hospital emergency departments, jails and probation facilities.

“We strongly encourage people who are at risk to check with their healthcare providers and get vaccinated for hepatitis A,” Dr. Wilma Wooten, county public health officer, said. “The two best ways to prevent hepatitis A are vaccination and good hand hygiene, which means washing your hands after using a restroom and before preparing or eating meals.”

Twelve hepatitis A cases have been reported in people who spent at least part of the time when they were potentially contagious incarcerated in county detention facilities. Most of these people were likely exposed to the disease before they were in jail. The new potential exposures may have occurred at the following facilities: George Bailey Detention Facility, San Diego Central Jail and East Mesa Detention Facility from May 6 to May 8.

People who have been exposed to hepatitis A should be aware that they can develop symptoms up to 50 days after exposure. The disease can be prevented if someone gets immunized within two weeks of exposure.

Hepatitis A can be spread through contaminated food or water. In addition to vaccination, it is important for everyone to wash their hands before preparing or eating food, and after using the bathroom or changing diapers. Hepatitis A can also be spread by having sexual contact or sharing drugs with someone who is infected.

Symptoms of hepatitis A include jaundice or yellowing of the skin and eyes, fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and light-colored stools. Symptoms usually appear over a number of days and last less than two months.

However, some people can be ill for as long as six months. Hepatitis A can sometimes cause liver failure and even death.

The best way to prevent hepatitis A is by getting vaccinated. The hepatitis A vaccine became available in 1995 and is recommended as part of the routine childhood vaccination schedule. However, many adults have not been vaccinated and may be susceptible to the hepatitis A virus.

In addition to children, hepatitis A vaccine is routinely recommended for

travelers to countries that have higher rates of hepatitis A, users of injection and non-injection illegal drugs, homeless people, men who have sex with men, people with chronic liver diseases, such as cirrhosis, hepatitis B or hepatitis C and household or sexual contacts of hepatitis A patients.

Because of the local outbreak, individuals who work closely with homeless people and illicit drug users on a frequent and ongoing basis, such as those who work or volunteer at homeless services agencies, are now recommended to get the hepatitis A vaccine, if they are not already vaccinated.

People are recommended to check their hepatitis A vaccination status and talk to their health care providers about the risks for hepatitis A. Persons planning an international trip should check the Centers for Disease Control and Prevention’s Travelers’ Health website to see if hepatitis A vaccination is recommended for the intended destinations.

Hepatitis A vaccine is available at many doctors’ offices and clinics and at some retail pharmacies. For persons without health insurance, the vaccine is available at county public health centers. For a list of locations, call 211 or visit http://www.sdiz.org.

For general information on hepatitis A, visit the HHSA hepatitis website where data are updated routinely. A fact sheet is also available.