Action over disease ordered

San Diego has five days to address hepatitis A outbreak among homeless.

SAN DIEGO — After weeks of delay, hand-washing stations were to start popping up in San Diego on Friday — one day after the county health department sent a letter demanding that the city improve sanitary conditions in areas where homeless people affected by an ongoing hepatitis A outbreak are known to congregate.

Tom Christensen, a spokesman with the county Health and Human Services Agency, said the first station was being installed in front of the Neil Good Day Center in downtown San Diego, and several more would be placed in Balboa Park.

The county outlined a plan that requires city workers to “take immediate action to address the unsanitary living conditions of the at-risk population,” according to the letter from Helen Robbins-Meyer, the county’s chief administrator, to Scott Chadwick, the city’s chief operating officer.

Actions that the city must take within five days include expanding access to public restrooms and wash stations, increasing the number of hand-washing stations and pressure washing of public right of ways on a weekly basis — including sidewalks, streets and gutters — to remove “all feces, blood, bodily fluids or contaminated surfaces.”

Underway since November, the outbreak has killed 15 people, most of them homeless residents or illicitdrug users, with 379 confirmed hepatitis A cases and more than 200 hospitalizations.

After months of slow progress in getting permits for hand-washing stations, as reported last week by Voice of San Diego, the county got more specific in its letter to the city. A total of 30 locations are specified for areas where homeless residents are known to gather.