Hundreds of cautionary safety measures lead to end of deadly outbreak
■ Kyle Selby / Reporter
Tuesday, Jan. 23, the San Diego County Board of Supervisors declared an end to the fatal hepatitis A outbreak in San Diego County. According to officials, the virus has not claimed a life within the county since October, and there have been no new reported cases in the last month. However officials are still keeping an eye on the epidemic.
“New outbreak activity has leveled off to near zero,” said Wilma Wooten, MD, San Diego County public health officer in a press release. “The sustained vaccination, sanitation, and education efforts we undertook will continue and we will remain vigilant to make sure that the outbreak activity doesn’t return.”
The hepatitis A virus (HAV) is a highly contagious liver disease transmitted most frequently when the fecal matter of an infected individual is consumed orally. This includes eating food or drinking liquids prepared by somebody who has not thoroughly washed their hands, but can also be transmitted through sex and illicit drug use. Poor hygiene and access to ill-managed bathroom facilities are large contributors to the spread of the virus, therefore it is found commonly among homeless populations.
The outbreak in San Diego began in Nov. 2016, and saw over 500 infected individuals and has killed at least 20. Other counties in California have recently experienced slightly smaller outbreaks, including Los Angeles and Santa Cruz counties. Other states like Colorado, Michigan, Utah and Kentucky also share similar parallels.
But what about Hemet or San Jacinto?
“Each infected individual is contacted, interviewed, tested, and [if necessary] removed from their setting as per protocol,” explained Barbara Cole from the County of Riverside Department of Public Health on Tuesday. “Thus far, we have not had any reports of hepatitis A in [Riverside County’s] homeless population.”
Cole reported that from Jan. 1 to Dec. 31, 2017, only 12 cases had been reported as positive hep A patients in Riverside County. This is just one more than the previous year’s total of 11 cases, and two less than 2015’s, which reported 14 cases.
She also gladly confirmed that Riverside County had not received any notice of any hep A cases for the entire month of January 2018.
One individual in the Riverside mid-county area near Hemet tested positive last November, but the case was not related to the outbreak in San Diego, and the person had soon been treated. Another man, from Riverside, also tested positive for hep A, but a genotype in his blood work did match that of the outbreak in San Diego. Much like the other patient, his condition was non-lethal, and he was able to seek the appropriate medical attention.
Symptoms of the virus generally take 15 to 20 days to surface, which include vomiting, fever, fatigue, loss of appetite and jaundice, which yellows the skin or eyes. Affected individuals are most contagious during the two weeks before jaundice becomes visibly noticeable.
San Diego County had been under a deadly hepatitis outbreak since November 2016, and just last year, the fatality mark had risen to claim 20 lives. On Oct. 26, 2017, a 67-year-old man was the most recent person to die from the virus, according to Dr. Eric McDonald, chief of the county’s Epidemiology and Immunization Services Branch. Typically, hepatitis A is not fatal.
In November, the U.S. Centers for Disease Control and Prevention (CDC) were having trouble supporting the demand of vaccinations and worked closely with counties such as San Diego to target the most critical patients. The demand had surpassed the average 1.2 million adult doses given in the US annually.
The vaccine has been proven to be more than 95 percent effective after the first dose, and nearly 100 percent effective after the second, which is recommended. Individuals who recover from the disease become immune to the disease for life.
More than 100,000 people in San Diego County have been vaccinated, now surrounded by dozens of hand-washing stations and bleach-cleaned streets.
While the hep A outbreak may be put to bed, another local epidemic is on the rise: the flu. There have been three local influenza-related deaths so far this season – ages 62, 82 and 88, at Hemet Valley Medical Center, alone.
The California Department of Public Health (CDPH) recommends washing your hands often, coughing and sneezing into your sleeve or a tissue, and staying home when you are sick. They also recommend getting a flu shot, and a hep A vaccination.