By Ken Williams | Editor

With 16 local people dead this year from hepatitis A and more than 400 infected by the virus, San Diego city and county officials are warning the public that those numbers are expected to rise before the crisis comes under control. In addition, health officials on Sept. 19 launched a “Vaccination, Sanitation & Education” campaign to urge residents to take up the challenge of helping to stop the spread of the virus.

Mayor Kevin Faulconer, County Supervisor Ron Roberts and county health officials spoke out about the urgent need for the public to take action to protect themselves, stressing the importance of residents washing their hands properly and getting most at-risk people vaccinated.

Free vaccinations are already available, the officials said. Call 211 or go to 211sandiego.org to learn more.

“Our county-led health teams have been mobilized since March to deal with an unprecedented outbreak that is primarily impacting San Diego County’s homeless and substance abuse communities,” Roberts said in a statement. “We need to continue our course of vaccination, sanitation and education efforts recommended by local, state and national public health officials and our own best practices.”

To date, the hepatitis A outbreak has impacted the homeless population the most. Health officials added that at-risk groups also include “intravenous drug users, food handlers, janitorial workers and occupations/professions that have regular interactions with at-risk people, such as police officers, firefighters, paramedics, homeless service providers and health care professionals,” according to a news release.

Hepatitis A is a highly contagious liver infection caused by the “hep A” virus, according to the Mayo Clinic. Symptoms include fatigue, nausea, abdominal pain, loss of appetite and a low-grade fever. Infected people may also experience pain in the joints or muscles, diarrhea, vomiting, dark urine, itching, weight loss, or yellow skin or eyes. If you experience any of these symptoms, seek medical help immediately.

The hep A virus is found predominantly in the stools of infected people. Highly contagious, the virus can be transmitted when people put something in their mouth that has been contaminated with the feces of an affected person, a process called fecal-oral transmission. According to emedicinehealth.com, the virus can spread through food or drinking water contaminated by an infected person; by eating raw or undercooked shellfish collected from water contaminated by sewage; blood transfusions; and sexual contact, especially oral and anal.

Although San Diegans are dying from the virus, health officials assured the public that the vast majority of infected people will fully recover from hepatitis A if treated. Residents can also take simple steps to help avoid the virus entirely by getting vaccinated or being extra careful with their hygiene.

Contamination can occur when infected people do not wash their hands properly after going to the bathroom and then touch other objects or food. Surfaces that are frequently touched should be cleaned and sanitized often, according the health officials.

“This is our community and we are working day and night to take care of it. It is going to require a sustained effort and everyone in San Diego County has a role to play,” Mayor Faulconer said in a statement. “Free hepatitis A vaccines are available thanks to the County of San Diego, American Medical Response and Downtown San Diego Partnership. San Diego is a healthy and safe community, and it will remain so as long as we follow the advice of our medical professionals.”

To avoid infection, public health officials recommend that people wash their hands regularly after using the bathroom and before preparing or eating food. Hands and arms should be washed with warm soapy water for at least 20 seconds and then thoroughly rinsed with clean running water and properly dried, according to the news release.

“There are precautions anyone can take to avoid getting hepatitis A,” said Dr. Nick Yphantides, Chief Medical Officer for the County Health and Human Services Agency (HHSA). “For those considered at-risk, they should get vaccinated. And all of us, whether we are considered at-risk or not, need to follow common sanitation habits, like washing hands with soap and warm water.”

According to the HHSA, the majority of people who have contracted hepatitis A are either homeless or illicit drug users, or both. So far, no common sources of food, beverages or drugs have been identified as the source or contributing factor in the current outbreak.

Dr. William Tseng, past president of the San Diego County Medical Society, said the region’s medical systems and providers are fully engaged in helping address the outbreak.

“Health care providers play a critical role in vaccination and patient education,” Dr. Tseng said in a statement. “We are committed as a medical community to work with our city and county leaders to aggressively respond to the hepatitis A outbreak.”

Responding to the outbreak, local officials have taken several actions, including:

• Offering free vaccinations. The county has been offering free vaccinations for several months, including sending nurses with vaccines into homeless encampments and other hepatitis A hotspots. More than 22,000 people have vaccinated to date.
• Installing 41 handwashing stations Downtown. The county installed handwashing stations to provide more opportunities for the public to stay clean.
• Sanitizing sidewalks and other public right-of-ways. At the county’s direction, the city last week began regularly sanitizing Downtown areas with a bleach solution to kill the virus. Other neighborhoods are expected to follow.
• Adding more public restrooms. The city has opened a new 24-hour restroom facility with four stalls near City Hall and another one at 1330 G St., bringing the total number of public restroom sites to 21 in the Downtown area. The operating hours of 14 restrooms in Balboa Park were also recently expanded to 24 hours a day.

Free vaccination clinics will be offered at public libraries through December. Here is a list of dates, times and locations:

• Monday, Oct. 9, 1-4 p.m., Logan Heights Library.
• Tuesday, Oct. 17, 2-5 p.m., San Diego Central Library, 330 Park Blvd.
• Friday, Oct. 20, 2-5 p.m., Valencia Park/Malcolm X Library.
• Tuesday, Nov. 21, 2-5 p.m., San Diego Central Library.
• Tuesday, Dec. 19, 2-5 p.m., San Diego Central Library.

For more information about getting vaccinated or learning about hep A, visit 211sandiego.org.

—Ken Williams is editor of Uptown News and can be reached at [email protected] or at 619-961-1952. Follow him on Twitter at @KenSanDiego, Instagram at @KenSD or Facebook at KenWilliamsSanDiego.