County health officials Tuesday reported the 18th death in the San Diego region's hepatitis A outbreak, among 490 total cases.
The county Health and Human Services Agency traced the outbreak to last November, with just under two-thirds of the victims being either homeless and/or drug users.
The latest fatality involved a 62-year-old man in the North County coastal area who already had medical issues, according to the HHSA. The agency's data show he is the first person from that part of the county to have died from the disease, which affects the liver.
The county and city of San Diego have taken several steps to address the outbreak, including a stepped-up immunization campaign that has resulted in more than 68,000 people being vaccinated, the spraying of a sanitizing formula on streets and sidewalks, and the placement of portable hand-washing stations and restrooms in areas where the homeless congregate.
Both jurisdictions have proclaimed a local health emergency. The county Board of Supervisors extended theirs for another two weeks.
"At first glance, there is a sloping effect and it appears the numbers (of cases) are decreasing, but because we know there is a long incubation period, we expect that more cases will occur," said Dr. Wilma Wooten, the county public health officer. "In recent weeks, cases are reported about two to three per day."
Wooten told the supervisors that the county is expected to spend about $1.5 million a month in connection with the outbreak moving forward.
So far, the county has spent $3 million in the response of the outbreak — with $2.5 million going to nurses and vaccines, and the rest covering the cost of sanitation efforts such as washing stations and hygiene kits.
Monday, the city of San Diego opened a 136-space tent camp in Golden Hill to provide a safe area for the homeless. The camp is in the parking lot of a city operations yard.
Critics contend that a shortage of shelter space for the homeless exacerbated the hepatitis A outbreak.