The Board of Supervisors Monday extended a state of emergency over a hepatitis A outbreak in San Diego County that has killed 20 people, amid a declining number of new cases.
Health officials told the supervisors at a special meeting that the drop in case numbers is a sign that efforts to fight the outbreak are working. They stressed the need for the county to continue vaccination, prevention and educational efforts that have been put in place since the emergency was declared in September.
There were 31 confirmed cases of hepatitis A last month, compared to a peak of 94 cases in August. There have been 544 cases as of Monday in the nearly year-old outbreak, an increase of 28 cases since data was last released on Oct. 24, according to Dr. Wilma Wooten, the county's public health officer.
She said some of those 28 cases include ones from as long ago as April that were newly confirmed by the U.S. Centers for Disease Control and Prevention. Due to the disease's long incubation period, there could potentially be more confirmed cases from October.
Wooten said the initial decline is a good sign, but not a reason to declare victory.
"We could potentially have a second peak," she said. "That's why it's very important for us to continue our vaccination efforts."
In San Diego, nearly two-thirds of the victims have been either homeless, users of illicit drugs or both. Much of the county's efforts have focused on those populations, but Wooten said an outbreak in Michigan that has affected men who have sex with men underscores the importance of targeting that community here.
Local efforts include holding vaccination events at LGBT centers and distributing educational information to clinics that serve that community, she said.
Around $5.5 million has been spent by the county to fight the spread of the disease, including administering over 90,000 vaccinations and spreading awareness among the public, according to county documents.
Hepatitis A is usually transmitted by touching objects or eating food that someone with the virus has handled or by having sex with an infected person. The disease doesn't always cause symptoms, but for those who do, they could experience fever, fatigue, nausea, loss of appetite, yellowing of the eyes, stomach pain, vomiting, dark urine, pale stools and diarrhea, according to the HHSA.
The county and city of San Diego have taken several steps to address the outbreak, including the spraying of a sanitizing formula on streets and sidewalks, the placement of portable hand-washing stations and restrooms in areas where the homeless congregate, and the stepped-up immunization campaign.