Hepatitis A outbreak may linger in state

People with the virus could travel and unknowingly infect others, doctors say.

California’s outbreak of hepatitis A, already the nation’s second largest in the last 20 years, could continue for many months, even years, health officials said Thursday.

At least 569 people have been infected and 17 have died of the virus since November in San Diego, Santa Cruz and Los Angeles counties, where local outbreaks have been declared.

Dr. Monique Foster, a medical epidemiologist with the Division of Viral Hepatitis at the U.S. Centers for Disease Control and Prevention, told reporters Thursday that California’s outbreak could linger even with the right prevention efforts.

“It’s not unusual for them to last quite some time — usually over a year, one to two years,” Foster said.

That forecast has worried health officials across the state, even in regions where there haven’t been cases.

Many are beginning to offer vaccines to their homeless populations, which are considered most at risk. Doctors say people with hepatitis A could travel and unknowingly infect people in a new community, creating more outbreaks.

San Diego County declared a public health emergency in September because of its hepatitis A outbreak.

Since November, 481 people there have fallen ill, including 17 who died, according to Dr. Eric McDonald with the county’s health department. An additional 57 cases are under investigation, he said.

Hepatitis A is commonly transmitted through contaminated food. The only outbreak in the last 20 years bigger than California’s occurred in Pennsylvania in 2003, when more than 900 people were infected after eating contaminated green onions at a restaurant.

California’s outbreak is spreading from person to person, mostly among the homeless community.

The virus is transmitted from feces to mouth, so unsanitary conditions make it more likely to spread. The city of San Diego has in-