An outbreak of hepatitis A in San Diego is being investigated by the Public Health Services Division, in the County of San Diego Health and Human Services Agency. Most of the people affected with hepatitis A are illicit drug users and homeless individuals. Hepatitis A is being spread from one person to another through fecal contamination.
In the current investigation no particular source of food, drugs or beverages have been identified. The Centers for Disease Control and Prevention (CDC) has warned however that the primary method of spread is from one person to another in United States.
As a measure to stop the spread of the infection, San Diego has started to wash its downtown streets with bleach. The homeless individuals living on the streets and the lack of adequate public restrooms has been thought to be one of the contributing factors to the outbreak. Vaccinations against hepatitis A virus are being offered to all individuals to protect them from the infection.
San Diego County Hepatitis A outbreak cases up until 12th September 2017 are 421. Of these 292 were hospitalized (69 percent) and 16 (3.8 percent) patients succumbed to the infection. The first case reported this year was in early March. Since then the numbers have steadily risen and earlier this month, hepatitis A was declared a public health emergency with extensive measures being taken to combat it.
The county issued a directive on 31st of August to start washing the streets and expanding the present number of public restrooms and their access in order to combat the outbreak. In its statement the county warned, “failure to immediately follow this directive will endanger public health and safety.”
The city has geared up to meet the directive and is targeting the downtown areas that are mostly frequented by the homeless individuals who are contracting hepatitis A and spreading it. Contractors are thus working to spray the areas with diluted household bleach solution this Monday through Wednesday and are likely to complete it by this weekend according to a city spokesperson.
They would be first spraying the areas with bleach covering all the dangerous items such as human waste or needles lying around. After a 10 minutes holding time, the contaminated items would be removed. Thereafter the areas would be sprayed again followed by a pressure-washing of the region with water. Each area is to be thus cleaned every two weeks, with weekly touch ups of the likely spots.
Hepatitis A
Hepatitis A is a viral infection that can damage the liver. Hepatitis A virus (HAV) is a very contagious and can lead to severe liver disease. Food and water that has been contaminated by a person who has HAV infection may transmit the infection. HAV can also be transmitted via unprotected sexual intercourse with an infected individual.
HAV infection may lead to a mild febrile illness initially. This includes fever, nausea, vomiting, loss of appetite, fever, yellowing of the eyes, dark urine and pale stools. There may be abdominal pain and diarrhea in some individuals.
The viral infection is preventable with vaccination. Twin vaccines against hepatitis A and B are used. Vaccines are recommended for travellers to areas where HAV infection is prevalent, homosexual men, injection drug users, those with chronic viral hepatitis infections with hepatitis B or C, homeless individuals, food handlers and those who work with homeless and other vulnerable populations.