U.S. communities reach out to homeless as liver disease surges

WORCESTER, Mass. - This industrial city in central Massachusetts has had many nicknames through the years, including “the Heart of the Commonwealth” and “Wormtown.” Among them was this less-known medical moniker: “Hepatitisville.”

Worcester has endured several outbreaks of the liver-battering disease, including one that sidelined 90 members of a college football team in 1969.

Given its history and its size, it wasn’t surprising Worcester was hard hit when recent hepatitis A outbreaks in the state started sickening - and killing - homeless people and illicit drug users.

The surge was part of a national rise in the viral disease. Outbreaks have popped up in 17 states in the last two years, leading U.S. health officials to recommend for the first time that a routine vaccination be given specifically to homeless people.

Some places have struggled to respond, watching deaths and illnesses mount. But this time, Worcester is a bright spot. City officials planned for an outbreak before it happened and used a coalition of agencies and community groups to meet homeless people where they live.

The relative success in Worcester has limited the illnesses and shown how long-term outreach to homeless people and drug users can pay dividends in times of crisis.

The outbreak, which first flared in September, seems to be petering out at 58 confirmed cases.

“I think we had a great response. Everybody came together,” said Worcester’s health commissioner, Dr. Matilde Castiel.