July 21, 2017
2 min read

California health officials battle state’s largest hepatitis A outbreak in 2 decades

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The California Department of Public Health is working with local health officials in San Diego and Santa Cruz counties to contain the state’s largest hepatitis A outbreak in 2 decades.

As of July 18, officials identified 251 cases and five deaths in San Diego, and 27 cases in Santa Cruz since the outbreak began in November, according to the California Department of Public Health (CDPH). San Diego’s Health and Human Services Agency reported that 69% of cases in the county required hospitalization.

A CDPH representative told Infectious Disease News that the overall case count is larger than that of all other hepatitis A outbreaks in California combined over the past 20 years. There were seven hepatitis A outbreaks in the state from 1998 to 2015, totaling 224 cases and one death.

“In addition to being the largest, this outbreak is different from most of the prior outbreaks because it is a result of person-to-person transmission and not caused by a contaminated product,” the CDPH representative said. “The population affected are persons who are homeless and/or report drug use.”

The CDPH said it will continue to provide technical assistance and hepatitis A vaccines to affected populations in San Diego and Santa Cruz.

“CDPH has issued statewide guidance regarding which groups of people to target for hepatitis A vaccination,” the CDPH representative said. “The homeless/drug-using population is very difficult to access for vaccination, so this guidance has been shared with community health care providers and also with emergency rooms, jails and organizations that work with homeless persons and/or drug users.”

The hepatitis A vaccine is routinely recommended for children, travelers to countries with higher rates of hepatitis A, homeless people, men who have sex with men, individuals with chronic liver diseases and household or sexual contacts of patients with hepatitis A. However, many adults have not been vaccinated against hepatitis A and are susceptible to infection, according to the San Diego health department. Because the outbreak largely affects homeless individuals and drug users, health officials recommend that unvaccinated workers and volunteers who interact with these populations be vaccinated. They are also urging people to practice good hygiene to avoid infection.

“It is imperative that anyone at risk for hepatitis A get vaccinated,” Wilma Wooten, MD, MPH, San Diego County public health officer, said in a press release. “We cannot stress this enough: Get vaccinated and make sure you wash your hands after going to the bathroom. Lives are at risk. Protect yourself, your family and the community.” – by Stephanie Viguers

Disclosure: Wooten reports no relevant financial disclosures.