Article By: DR. SEJAL N. PATEL
As California finds itself in the grips of the largest person-to-person hepatitis A outbreak in more than 2 decades, health officials are taking emergency measures to curb the spread of the deadly disease.
On Friday, California Governor Jerry Brown declared a State of Emergency in light of the outbreak that has killed at least 18 people, hospitalized 386 & infected at least 578 in the state as of this past weekend, according to the California Department of Public Health (CDPH).
“This outbreak is different than any other we have seen in the United States in the past decade,” said Dr. Matt Zahn, medical director of epidemiology at the Orange County Health Care Agency. “Previously, we have seen outbreaks that are food-borne with a direct exposure to that food source. Ongoing person-to person spread is really not something we have seen in recent years.”
Also unique about this outbreak is that the homeless population & illicit drug users are the hardest hit.Hepatitis A is a vaccine-preventable disease & the Governor’s state of emergency proclamation has given the CDPH the authority to directly purchase vaccines from manufacturers in order to quickly distribute them to the community.
“The key is to bring the vaccination directly to the communities at risk,” Zahn said. “This population is not easy to reach, so we make interventions to bring it to them. San Diego has done a marvelous job to have their staff go out to the homeless community, individual by individual, & offer the vaccine then & there.”
The outbreaks are affecting multiple counties in California w/the San Diego Jurisdiction bearing 490 infected cases. Since early spring, more than 80,000 vaccine doses have been distributed to the public & some municipalities have purchased their own supplies. San Diego County said it has administered more than 68,500 vaccines since the outbreak began.
Sanitation & hygiene are other important aspects of controlling the spread of hepatitis A, which is spread through fecal matter. Since the outbreak began in the spring, more than 100 hand washing stations have been installed in the area, most of which are in the city of San Diego. The city is also power-washing areas affected public areas w/bleach solutions & making public bathrooms more available in areas most frequented by the homeless.
Below are answers to commonly asked questions about this disease:
How is Hepatitis A spread?
Since this virus spreads through feces, outbreaks are most commonly seen in the presence of unsanitary conditions or behaviors. Food workers can spread the virus if they do not properly wash their hands after using the bathroom & caregivers can transmit the virus after changing the diaper of an infected baby.
Hepatitis A can spread by simply touching objects, or through contaminated food or drinks. People may also be infected by eating uncooked food that has been contaminated, sexual contact w/an infected person & travel to a country where Hepatitis A is common. The virus can be spread to others before any symptoms are apparent.
What are symptoms of Hepatitis A?
The hepatitis A virus causes inflammation of the liver. Symptoms of infection include fever, fatigue, abdominal pain, nausea & vomiting. Yellowing of the skin & eyes, also know has jaundice, is also a possible symptom of this virus. Hepatitis A is an acute infection w/symptoms persisting for up to 2 months; rare cases may last longer. The virus does not typically lead to chronic infection or death, but it can prove fatal to those w/compromised livers or immune systems.
How to protect against the virus
The best way to prevent getting Hepatitis A is through vaccination, given in a 2-dose series, according to the U.S. Centers for Disease Control (CDC). The vaccine is especially recommended for those at particularly increased risk, such as people w/chronic liver disease, blood clotting disorders, men who have sex w/men, those traveling to areas known to have the virus, such as parts of Africa & Asia, & those who could be in direct contact w/people infected w/hepatitis A, like health care workers.
The virus can live for months outside of the body on objects & surfaces, according to the CDC, & it can be difficult to kill.
“Hepatitis A is a hardy virus, & can certainly stay on surfaces & in the environment [for a long time],” Zahn said.
Importantly, most waterless hand sanitizers & some household cleaners are not effective in destroying the virus. So when it comes to preventing spread, washing hands thoroughly & regularly w/soap & water is the best bet. Using bleach-based cleaning products is the most effective to clean surfaces in a way that eliminates the hepatitis A virus.