Hep A Emergency Declaration Extended Again

County nurse Jackie Kersey-Hardrick vaccinates a man in East Village.
County nurse Jackie Kersey-Hardrick vaccinates a man in East Village.

The local health emergency declared on Sept. 1 because of hepatitis A will remain in effect for another two weeks as the County continues working to control the outbreak.

The County of San Diego Board of Supervisors, which is required to review the need for continuing the declaration every 14 days, voted Tuesday to extend it through October 24.

As part of the review, Wilma Wooten, M.D., M.P.H., County public health officer, updated the board on the County’s actions to halt the outbreak with increased efforts in three key areas: vaccination, sanitation and education.

Through Oct. 7, there have been 490 cases associated with the outbreak, including 18 deaths and 342 people hospitalized. The Health and Human Services Agency and the local health care community have given 68,500 vaccinations since the outbreak began, including nearly 54,000 to the at-risk populations.

More than 36,000 vaccinations have been given by local health care systems, community clinics and pharmacies in the county. About 21,600 of them have been given through mass vaccination events, mobile vans and foot teams that continue to hit the streets to target the homeless population. An additional 10,800 shots have been given to local food handlers and at-risk professionals.

Who should get vaccinated?

During this outbreak, the people who are most at risk are homeless people or users of injection or non-injection illegal drugs. People who work with or clean up after homeless individuals and/or users of illegal drugs are also at risk. Vaccination efforts should also continue to other established at-risk groups and those who have been recently recommended to get vaccine due to the outbreak.

The risk groups identified by CDC since 2006 include:

  • Users of injection or non-injection illegal drugs
  • Men who have sex with men
  • People with chronic liver disease, such as cirrhosis, hepatitis B or hepatitis C
  • Travelers to countries with high or medium rates of hepatitis A virus
  • People with clotting factor disorders

Because of the ongoing hepatitis A outbreak, the County Health and Human Services Agency is also recommending that the following people be vaccinated as well:

  • People who are homeless
  • People who work on a close and ongoing basis with or clean up after homeless individuals and/or users of illegal drugs
  • Food handlers

Sanitation efforts are also increasing. There are 99 handwashing stations placed around the county with the majority in the City of San Diego.

The County has also distributed over 6,400 hygiene kits to the at-risk population. The kits include hand sanitizer, cleansing wipes, bottled water, a waste bag and information on preventing hepatitis A.

In conjunction with the County Department of Environmental Health, an extensive education campaign is ongoing with food handlers and restaurants.

Hepatitis A is most commonly spread person-to-person through the fecal-oral route. Symptoms of hepatitis A include jaundice (yellowing of the skin and eyes), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, and light-colored stools.  Symptoms usually appear over a number of days and last less than two months.  However, some people can be ill for as long as six months. Hepatitis A can sometimes cause liver failure and even death.

For general information on hepatitis A, visit the HHSA hepatitis website where data are updated routinely. A hepatitis A fact sheet is also available.

José A. Álvarez is a communications specialist with the County of San Diego Communications Office. Contact