Hepatitis A outbreak continues to simmer in San Diego
SAN DIEGO — Four new cases show that, while it’s not as bad as it was in 2017, San Diego County’s hepatitis A outbreak is not yet extinguished.
Weekly public health reports this week and last have each added a pair of newly-confirmed cases to the outbreak total. Although that’s nowhere near the number of new cases that flooded in every week in August and September, it’s still a faster pace than the roughly every-other-week frequency that government records show San Diego County averaged before from 2012 through 2016.
“The outbreak is not over, and the most recent cases seem to be slightly geographically skewed to the northern part of the county,” said Dr. Eric McDonald, chief of the county’s Epidemiology and Immunization Services Branch.
Largely spread among the region’s homeless population, that has not necessarily been the key demographic characteristic of the latest outbreak-connected hepatitis A cases. McDonald said three of the four cases were drug users but only one of those was homeless. The fourth was a family member of a person who was already known to have an active hepatitis A infection.
“The individual was advised to get vaccinated to prevent illness, but chose not to do so. Most people get vaccinated promptly when we advise it,” McDonald said.
He added that two of the four cases were evenly split among coastal and inland North County, but the zip codes where each case occurred were not immediately available.
To date, the outbreak has generated 582 cases. The viral liver infection has hospitalized nearly 400 people since November 2016 and has killed 20. Hepatitis A, which spreads through fecal contamination, is not usually fatal unless a patient has other co-occurring illnesses such as immune system deficiencies or other liver diseases, including hepatitis B and hepatitis C.
Desperate to end the outbreak’s rapid spread, San Diego County officials declared a local health emergency on Sept. 1, 2017, canceling the directive on Jan. 23 once it appeared that the crisis was under control.
McDonald said outreach efforts are continuing in coastal and inland North County with vaccination foot teams working to deliver doses to homeless residents. Shelters and substance abuse treatment centers are also being asked to make sure their clients have been immunized.
The county has 10 handwashing stations in different North County locations and will continue their maintenance through the end of March, according to county spokesman Craig Sturak. There had been 250 vaccination events held in North County from Dec. 1, 2017 through Feb. 22 with 31 more scheduled through Mar. 31, Sturak added in an email.