New Vaccination Recommendations Issued for Hepatitis A Outbreak

The ongoing hepatitis A outbreak in San Diego County has claimed 14 lives and hospitalized 246 people among the reported 352 cases.

Approximately 70 percent of the cases have been among people who are homeless, use illicit drugs or a combination of those two factors.

The County has been increasing efforts to vaccinate these target populations as well as those who come in contact with them.

The County’s public health officer has now made recommendations that people who handle food get a vaccination for hepatitis A.

“This is a pro-active recommendation because the ongoing outbreak means that the risk to the general public is higher than normal,” said Wilma Wooten, M.D., M.P.H., county public health officer.

“A person who becomes infected with hepatitis A may spread the disease to others before experiencing symptoms. In an occupation such as handling food, workers may expose more members of the public than workers in other occupations.”

No common sources of food, beverage or drugs have been identified that have contributed to his outbreak, although the investigation continues.

Food handlers can get the vaccination from their occupational health provider, health care provider, or a local pharmacy that carries the vaccine. A prescription is not needed to get the vaccination.

The vaccine is also available to uninsured or under-insured individuals for no cost at all County public health centers. For a list of locations, call 2-1-1 or visit

The vaccine recommendation has also been expanded to those who work in health care in addition to prior recommendations for those who work in public safety, sanitation, homeless shelters and behavioral and homeless service providers. A hepatitis A vaccination is the best way to prevent the disease.

HHSA is continuing to work with a wide range of community partners on a variety of strategies to offer vaccinations and deploy increased education efforts to people at risk for getting hepatitis A.

Homeless service providers, treatment providers, faith-based community organizations and the Regional Task Force on Homeless are all helping notify high-risk individuals about the outbreak. Ads encouraging people get the hepatitis A vaccine have been placed in Metro Transit buses, trolleys and stops.

The local medical community, including hospital emergency departments and community health clinics, and the County jail and probation facilities, has been helping administer vaccinations.

Teams of public health nurses, often partnered with a community outreach worker or a member of law enforcement through the various Homeless Outreach Team, are continuing to go into the community on “foot teams” to offer homeless people vaccinations.

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.

Hepatitis A can also be prevented through good hygiene.  Everyone should:

  • Wash their hands for 20 seconds (about the length of time to sing “Happy Birthday” twice) with soap and running water before eating and after using the restroom or changing a diaper
  • Do not directly touch the door handle when exiting a public restroom
  • Do not share food, drinks, or smoking materials with other people

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

Tom Christensen is a communications specialist with the County of San Diego Communications Office. Contact