Hepatitis A San Diego outbreak causes health emergency

San Diego has declared a public health emergency to control a wildly spreading outbreak of the liver disease hepatitis A that has killed 15 people.

Infections have hospitalized nearly 400 more with the homeless population hit the hardest since the outbreak started last November.

Officials have attempted to use a combination of education and vaccination methods to prevent the spread of this virus, but the outbreak has only grown.

Hepatitis A can spread through ingesting food and drinks that have come in contact with feces from people who are already infected.

Officials are now moving fast to install hand-washing stations in areas more populated by homeless people to contain the spread of the deadly virus.  

The hepatitis A outbreak in San Diego County has killed 15 people and hospitalized close to 400. Workers such as Edwin Gonzalez (pictured) from United Site Services delivered hand-washing stations to areas around the county to promote people washing their hands 

Friday’s emergency declaration will help San Diego County get state assistance and legal protection over its new sanitation measures.

Some of the sanitation measures San Diego County has implemented to stop the hepatitis A outbreak include 40 portable hand-washing stations in areas with large homeless populations. 

Hepatitis A is a virus that lives in human feces and spreads if people who use the bathroom don’t properly clean their hands.  

If people then ingest food or drinks containing the virus, they are at risk of getting infected.  

What is hepatitis A and how can it be treated? 

Hepatitis A is a viral liver disease that can have both minor and severe symptoms for the person infected. 

It is primarily spread when a person who isn’t vaccinated ingests food or water that has been contaminated with feces of an infected individual.

The virus is one of the most frequent causes for foodborne infections.


The incubation period of hepatitis A is normally 14 to 28 days. 

People can experience:

  • Fever
  • Loss of appetite 
  • Diarrhea 
  • Nausea 
  • Dark-colored urine
  • Jaundice 
  • Acute liver failure 

Who is at risk?

Anyone who has not been vaccinated or has never been infected with the hepatitis A virus is at risk. 

Other factors that increase risk include:

  • Poor sanitation
  • Lack of clean water
  • Recreational drug use
  • Living with an infected person or having sexual relations with one
  • Traveling to areas with high risk without a vaccination


There is no specific treatment for hepatitis A. 

It may take some people a couple weeks to a couple months to recover from the symptoms. 

Doctors recommend everyone to get a vaccination to help prevent the risk of getting infected by the virus.  

Source: World of Health

People can experience symptoms such as fever, loss of appetite and diarrhea, which can last a few weeks to a few months depending on the severity of the infection.  

Crews are also planning to use bleach-spiked water for high-pressure washing to remove ‘all feces, blood, bodily fluids or contaminated surfaces,’ according to a sanitation plan included in a letter delivered to San Diego city government Thursday.

In the coming weeks, other cities in the region will see hand-washing and street-sanitizing efforts, said Dr. Wilma Wooten, the region’s public health officer.

Vaccination and education about hepatitis A had been San Diego County’s main preventative strategy.

But thousands of doses of vaccine were distributed, death and infection rates have accelerated.

The new sanitation measures were inspired by a prior campaign in Los Angeles, home to tens of thousands of homeless.

‘We know that L.A. has had no local cases of hepatitis A related to the strain that we’re seeing here in San Diego,’ Wooten said. 

‘If they’re doing it there and they haven’t had any cases, it could be beneficial here as well.’

It is rare for hepatitis A to cause death, but if it is severe enough it will lead to acute liver failure and kill the infected individual. 

‘There is no precedent for this,’ Wooten said. 

‘We will definitely have a playbook for if we have something like this in the future, but this is the first time we have had something of this nature happen.’ 

Another outbreak in 2003 linked to green onions in Pennsylvania caused three deaths and sent 124 people to hospital.

Hawaii also experienced an outbreak from sushi at the end of 2016 that caused 300 people to become infected.

Authorities have not yet identified the cause of the latest outbreak.

In June, officials had stores throw out pomegranate seeds that were potentially carrying the hepatitis A virus, according to The San Diego Union-Tribune.

But they say it is being spread person-to-person and through contact with a fecally contaminated environment.

This puts homeless people especially at risk since they do not have regular access to sanitary facilities and clean water to wash their hands, state health authorities noted.

People are advised to wash their hands for at least 20 seconds with soap and to avoid touching bathroom handles. 

Officials recommend for people to get vaccinated in order to prevent getting the disease. Hepatitis A can spread from ingesting food or drinks that have come in contact with feces from someone who has the virus. People should wash their hands before eating anything

Officials recommend for people to get vaccinated in order to prevent getting the disease. Hepatitis A can spread from ingesting food or drinks that have come in contact with feces from someone who has the virus. People should wash their hands before eating anything

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