Hepatitis A shot
A hepatitis A shot is administered. Photo by Chris Stone

More than 10,500 people in Los Angeles County have been vaccinated against hepatitis A in response to the recent outbreak, health officials said.

That includes nearly 3,500 homeless individuals and another 3,000-plus jail inmates and parolees.

Gov. Jerry Brown has declared a state of emergency over the outbreak of the disease that has killed at least 18 people. It’s the greatest spread of “hep A” in more than two decades.

The individuals at highest risk are those living in unsanitary conditions on the street, active illicit drug users and men who have sex with men, Public Health Director Barbara Ferrer told the board Tuesday.

Clinical and social service workers, sanitation employees and food service employees who work with the homeless or in areas where they camp out are also at risk.

Even those without symptoms can spread the virus and the infection can continue to spread for at least a week after symptoms show up, Ferrer said.

Los Angeles County has just 13 confirmed cases related to the outbreak and no deaths, compared to 490 in San Diego, where 18 people have died from the virus.

But as long as there’s a major outbreak in San Diego, “we will see more cases here,” Ferrer warned.

Arizona and Utah also have outbreaks, though much smaller in scale than San Diego.

Ferrer said “the homeless population travels” and told the board there was typically an uptick in the local homeless population as cold weather strikes other cities, mentioning an outbreak as far away as New York.

Supervisor Janice Hahn challenged the department’s vaccination strategy, pointing out that nearly 58,000 people are homeless countywide, based on the last point-in-time count.

“I don’t see a real robust strategy,” Hahn said.

Hahn also questioned Ferrer about which elected officials she’d contacted.

“I feel a real disconnect on what I’m hearing out there on the streets about this outbreak and our attempt to try to get more sanitation equipment, more showers, more sinks,” Hahn said.

The board voted last week to survey homeless encampments to determine where to locate more public restrooms and handwashing facilities.

Hepatitis A is a highly contagious liver disease and the risk is particularly great among homeless individuals who are often living in unsanitary conditions, suffering from other health issues or don’t have ready access to treatment.

Some individuals with hepatitis A may not have any symptoms, while others may suffer mild symptoms over a period of weeks that can be treated with rest, good nutrition and fluids.

Most people recover completely. However, those who have other health issues or weakened immune systems can suffer permanent liver damage and even death.

The mortality rate in San Diego has been significantly higher than officials would expect. The virus is usually less deadly than the flu, killing about 1 percent of those who contract it.

Contagion occurs through contact with feces via surfaces or sexual contact, so keeping hands clean is a big part of preventing spread of the virus.

—City News Service

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