Health officials tackle spread of virus
stalled dozens of handwashing stations and begun cleaning streets with bleachspiked water in recent weeks.
McDonald said county health workers had vaccinated 57,000 people in the county who were homeless, drug users or in close contact with either group.
“The general population — if you’re not in one of those specific risk groups — is at very low risk, and we’re not recommending vaccinations,” he said.
The outbreak has also made its way to Santa Cruz and L.A. counties, where 70 and 12 people have been diagnosed, respectively.
Officials from both counties say they’ve vaccinated thousands of homeless people and will continue to do so.
New cases linked to the outbreak might not appear for weeks because it can take up to 50 days for an infected person to show symptoms, said Santa Cruz public health manager Jessica Randolph.
“I don’t think the worst is over,” Randolph said.
Tenderloin Health Services, a clinic in the San Francisco neighborhood known for its large homeless population, has been offering hepatitis A vaccines to its patients for weeks. The clinic recently held an event in which workers gave shots to 80 people in three hours, said Dr. Andrew Desruisseau, the clinic’s medical director.
“The cases in San Diego and the magnitude of the epidemic there certainly set off alarms in the Bay Area,” he said.
So far, there have been 13 hepatitis A cases in San Francisco, but none associated with the outbreak.
Desruisseau said 90% of the clinic’s patients were homeless and many had other liver problems or were drug users, making the disease especially dangerous.
Typically, only 1 out of every 100 people with hepatitis A dies from the disease, but it appears to have killed a higher rate of people in San Diego because of the population affected, experts say.
All 17 people who died in the San Diego outbreak had underlying health conditions, including 16 who had liver problems such as hepatitis B or C, McDonald said.
Desruisseau said he was particularly concerned about conditions on the streets in San Francisco.
“With all of the housing crisis and gentrification in San Francisco, we’re seeing a much more condensed homeless population,” he said. “We have a lot of obstacles in keeping it a very sanitary place for our clients.”
Doctors and nurses in several California counties are beginning to offer vaccines to their homeless populations, as recommended by the state health department. Typically only children and people at high risk are vaccinated for hepatitis A.
In Orange County, which has had two hepatitis A cases linked to the outbreak, public health workers have given out 492 vaccines, mostly to homeless people, officials said. County nurses have also been visiting shelters and parks to vaccinate people.
Some officials, including in Riverside and Sacramento counties, said they were reviewing their sanitation protocols for homeless encampments.
A Los Angeles councilman recently called for more toilets in neighborhoods such as skid row and Venice in light of the local hepatitis cases.
Many have blamed San Diego’s outbreak on a lack of public bathrooms near homeless encampments.
In Oakland, city workers represented by SEIU Local 1021 sent a letter to City Hall last month saying they feared a hepatitis A outbreak in the region’s homeless community.
So far, there haven’t been any cases in Oakland or the rest of Alameda County, but city safety steward Brian Clay said he believed the city had allowed unsanitary conditions in homeless encampments.
Oakland city officials did not respond to a request for comment.
“There’s syringes, there’s human feces, there are dead animals, rats alive and dead rats … pee bottles, five-gallon buckets used as toilets,” Clay said. “We’re definitely concerned about this added threat of hepatitis A.”