On September 1, 2017, San Diego County officials declared a state of emergency due to a major outbreak of Hepatitis A in the region.
Since November 2016, 544 infections and 20 deaths have been reported. In comparison, for the last five years, San Diego County has recorded only 28 cases annually on average. Among the recent outbreak of reported cases, the majority have been homeless individuals and/or illicit drug users, including those who associate with them. The remaining population of reported cases has been from individuals lacking documentation.
Hepatitis A (HAV) is a viral infection leading to inflammation of the liver, which is usually transmitted through contaminated food or water. It can also spread through person-to-person contact via the fecal-oral route or via direct contact with HAV infected bodily fluids as with sexual contact. HAV transmission has also been epidemiologically linked to infected food handlers.
When a person infected with the virus doesn’t wash his or her hands after using the bathroom, everything in the environment that is contacted can become contaminated. When people touch a contaminated surface and fails to wash their hands before eating, or consumes contaminated food or drink, they, too, may become infected with the virus.
Symptoms include fever, fatigue, nausea, loss of appetite, yellowing of the eyes (jaundice), stomach pain, vomiting, dark urine, pale stools, and diarrhea. Some individuals will experience no symptoms whatsoever. Typically, symptoms usually last around two months with an expected full recovery for most healthy individuals. However, symptoms may last as long as six months for individuals with suppressed immune systems or those with other health-related diseases. While symptoms may be acute and severe, the recommended treatment for infection usually involves ensuring adequate rest, increasing fluid intake, and practicing good nutrition. Antibodies produced as a result of infection last a lifetime and will protect against a re-infection.
Since HAV infection is primarily transmitted through poor hygiene of infected individuals, the methods employed to combat the spread of infection by health officials in San Diego County are to increase sanitation in public restrooms, deploy over 100 hand washing stations in public areas, disseminate information to increase public awareness, and vaccinate at-risk individuals. Other considerations include placing mobile showers and clothes washing stations in areas where homeless populations congregate. Due to an emergency declaration, additional State and Federal funding is likely to become available to support this effort.
by Marcus Zuzow