San Diego claims end to deadly hepatitis A outbreak

SAN DIEGO — Two years in, San Diego’s hepatitis A outbreak is finally over.

Dr. Wilma Wooten, the county’s public health officer, said Monday that enough time has now passed to formally declare a curtain call for the contagion that killed 20, sickened nearly 600 and spurred a complete rethink of how the region handles homelessness.

“Last Thursday, it was officially 100 days since the mostrecent case, and, for hepatitis A, that’s the threshold we use that allows us to say it no longer meets the definition of an outbreak,” Wooten said.

Detected by the health department in late February 2017, infectious disease sleuths tracked the first likely case to the week of Nov. 22, 2016. By late spring of last year, there were hundreds of cases, a dozen deaths and a growing public outcry that something had to be done about the unsanitary living conditions among the region’s homeless population.

Under significant pressure from many who work with the homeless day in and day out, the city and county government came together in September to promote vaccination and sanitation, launching street-washing campaigns, installing portable toilets and hand-washing stations and, eventually, putting up temporary shelters large enough to house 700 people at a time.

With a cost estimated to exceed $12 million, fighting the outbreak didn’t come cheap, but that expense was what it took to address years of deferred maintenance for the homelessness problem, noted Bob McElroy, chief executive of Alpha Project.

Today, Alpha Project is one of several organizations operating new shelters and McElroy says he is convinced hepatitis A was the sad proof that homelessness can’t be ignored forever.

“The reality is, if you’ve got a place for people to be safe and have access to health care, you’re just not going to have the kinds of sanitation issues you have with tent cities lining the streets,” McElroy said.

Though San Diego’s outbreak was significantly wound down by the first of the year — there have only been 15 new cases in 2018 — other communities across the nation are still fighting.

An outbreak map maintained by the U.S. Centers for Disease Control and Prevention links to the latest outbreak updates in a dozen states, with Kentucky’s latest post showing 2,275 cases and 14 deaths; West Virginia lists 1,671 cases as of Oct. 26, and Michigan, whose outbreak began in August 2016, is now up to 898 cases and 28 deaths.

Nationwide, the combined case totals have now surpassed 8,000 with 76 deaths and more than 4,500 hospitalizations. On Thursday, the CDC is set to release a comprehensive report for all outbreaks in 2017 that should shed additional light on the situation.