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KPBS Midday Edition

Number Of Hepatitis A Cases In San Diego County Continue To Rise

Mindy Coughlin, left, and Heidi Unruh, center, both San Diego County Health and Human Services Agency Public Health Nurses and an outreach worker from Friend to Friend talk to a homeless person about getting the hepatitis A vaccination in downtown San Diego in this undated photo.
County of San Diego
Mindy Coughlin, left, and Heidi Unruh, center, both San Diego County Health and Human Services Agency Public Health Nurses and an outreach worker from Friend to Friend talk to a homeless person about getting the hepatitis A vaccination in downtown San Diego in this undated photo.

This is the largest outbreak in California in the past 20 years

Number Of Hepatitis A Cases In San Diego County Continue To Rise
Number Of Hepatitis A Cases In San Diego County Continue To Rise GUEST: Dr. Sayone Thihalolipavan, deputy public health officer, San Diego County

Our top story on midday edition new information released by San Diego county shows the number of hepatitis A cases continues to rise. Since November 196 cases have been reported and four people have died. Making this the largest hepatitis A outbreak in more than two decades and one of the largest in the nation's since the vaccine was introduced. The virus is affecting the county's homeless population. Public outreach campaign has been underway for several months. The counties planning on opening handwashing stations to try to put a break on the spread of the disease Hurco joining me is Doctor Sayone Thihalolipavan . Start us off with some of the basics of hepatitis a. How does it differ from hepatitis B and hepatitis C. It is a contagious liver disease. Hepatitis is different because it is also a virus but it spreads from ingestion of contaminated fecal matter and you just need a microscopic amount to get hepatitis A. So the best protection is vaccination and good hygiene. What kind of symptoms this hepatitis A cost question mark It causes flulike symptoms in the beginning fever, we could, tired and then some people get the classic symptoms like the jaundice and then some people get Coca-Cola year-end -- urine. The challenges with this outbreak is that it can take up to 50 days for someone to show symptoms. Wise and sometimes fatal? Most people who get the illness really recover in a few weeks. Some people who are over 50 and have medical complications are those that are more likely to have a worse scenario and a longer-lasting scenario and a more severe scenario. We typically need hundreds of cases to see death but we've already seen four deaths. This is a indication for us that we are not even seeing in our case count all of the activity that is going around in the county. Within two days we got referred 21 cases to work on and that 21 cases is how many confirmed cases we get a year. It is my understanding that most hepatitis A outbreaks are traced back to a common food source or beverage. Could that be the case this time? That is true. What most of us hear about is contaminated food or water and we will hear about frozen Cosco berries that were recalled and for this outbreak we have worked with our environmental health department and got out to the sites where we've seen a lot of cases and looked at the way they are handling food and tested them and have not come up with any indication that there is a common source in terms of food. We think this outbreak is by person-to-person contact. According to a story in the newspaper some people are finding a link between this outbreak and the new plastic bag ban. Many homeless people use the plastic bags to either store their food to try to keep it sanitary or to go to the bathroom. Has that come up in your investigation? It has. That could be a possibility. It is really challenging to investigate that. It is unlikely that the only source and only reason. We don't have -- it's hard to have hard data to support that. The county says it's doing outreach to try to stop the spread of the disease. What does that consist of question mark Unique challenges especially with these populations require unique efforts and partnerships. So we have these teams and nurses going out there with cooler backpacks and vaccines and they're going out there to talk to the homeless individuals and offering vaccines on the streets in the field. We are working with local departments that are affected and having them try to screen and offer vaccines to these populations. A lot of these individuals are coming through and really trying a lot of these different approaches. We are trying to do vaccine clinics that they seek services. What about these handwashing stations planned where will they be in about how many? Vaccination is the best strategy because regardless of what happens you can always vaccinate people. There is the other hygiene component. We are exploring the handwashing station idea, which will work out and will be a great idea so we are trying to pilot some county owned property and looking at other sites that we have contractors or the places where the providers are willing to allow us to be there. Are any plans for Downtown San Diego question Mark Yes, we also do have cases in other counties as well. We are primarily focusing on downtown. Many of the homeless people that I have seen quoted in newspapers about hepatitis A outbreak are saying we have no place to maintain any sense of personal hygiene. Do you think the idea aside from handwashing stations some sort of portable bathrooms or showers downtown actually could be looked at from a public health standpoint at this point? Yes. That requires further discussion, of course. That is something that we want to look into as we are exploring the hygiene perspective. I've been speaking with Doctor Sayone Thihalolipavan . Thank you so much. No problem. Thank you.

There is no sign San Diego County's hepatitis A outbreak is slowing down anytime soon.

According to a new report by the San Diego County Health and Human Services Agency, there are now 196 confirmed cases of the viral disease, 142 hospitalizations and four deaths, making this the largest hepatitis A outbreak in California in more than two decades and the third largest in the nation since the hepatitis A vaccine was introduced in the late 1990s.

The overwhelming majority of the people affected are either homeless, drug users, or both.

The outbreak has forced health officials to resort to unconventional methods. They include sending out teams of nurses with backpacks and coolers to encampments, where they offer vaccinations. The county is also planning to install hand-washing stations in downtown San Diego and elsewhere to try to help prevent the spread of the disease.

Hepatitis A is spread through close contact and fecal contamination, and it leads to symptoms like nausea and jaundice.

County health officials expect the number of cases to continue to climb as dozens of suspected cases could soon be confirmed.

There has been no confirmed source of the outbreak.

Dr. Sayone Thihalolipavan, San Diego County's deputy public health officer gives an update on the outbreak Wednesday on Midday Edition.