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East County News Service

February 21, 2023 (San Diego) -- The County of San Diego has confirmed five hepatitis A cases, including one death, with illness onset between Jan. 10, 2023 and Feb. 6, 2023. Three of the cases were persons experiencing homelessness (PEH), including the person who died. Of the five, there are no known direct contacts and the five cases do not meet the definition of an outbreak as the County normally sees two to three cases per month.

“As a long-time healthcare advocate, I understand the importance of being out in front and transparent with the public about potential threats to the public health,” said Board of Supervisors Chairwoman Nora Vargas. “The disease is 100 percent preventable, and we want to ensure everyone living in our communities, including people experiencing homelessness, have the information they need to live a healthy and safe life.”

“The City is working closely with the County of San Diego to monitor the situation and facilitate vaccinations at our shelters,” said Mayor Todd Gloria. “During the past year and a half, our collaboration and early action prevented the spread of both shigellosis and monkeypox, and we’re taking that same proactive approach in this case to ensure the safety of all San Diegans.”

None of the cases are directly connected to any other, and no common food, beverage, or drug sources have yet been identified. None of the individuals had a hepatitis A vaccination on record. Vaccinations were given today (Monday) at a homeless shelter with an identified case, with 50 residents accepting vaccinations. The County will be on-site to provide vaccinations again tomorrow.

“While the investigations continue, we are asking health care professionals to be alert for patients who may show signs of hepatitis A,” said Dr. Ankita Kadakia, deputy public health officer. “Early identification of contacts and isolation are keys to prevention, as is the vaccination of at-risk populations.”

The County is also communicating with those who work with the homeless population and will work with all agencies and providers on sanitation and prevention strategies, including vaccinations, while the investigation continues.

Monitoring of hepatitis A cases in San Diego County is an ongoing process for early detection of disease clusters and cases are regularly reported. The most recent increase in hepatitis A cases among San Diego County residents occurred in early 2022 and was part of a national outbreak associated with organic strawberry consumption. A large local hepatitis A outbreak began in late 2016 among PEH and persons using illicit drugs. This outbreak had 592 confirmed or probable outbreak-related hepatitis A cases, including 20 deaths, before ending in October 2018.

In addition to hepatitis A vaccine being a routine childhood immunization, CDC has identified groups who should also be vaccinated, including:

  • International travelers.
  • Men who have sex with men.
  • People who use illicit drugs
  • People experiencing homelessness.
  • People with occupational risk for exposure.
  • People with chronic liver disease or HIV

People concerned about hepatitis A infection should contact their health provider.

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