The San Diego Health & Human Services Agency stated that the majority of people who have fallen ill because of hepatitis A are “homeless and/or illicit drug users, although some cases have been neither,” UPI reports.
The report added,
The outbreak is being spread person-to-person and through contact with a fecally contaminated environment. No common sources of food, beverage or drugs have been identified that have contributed to this outbreak, though investigation is ongoing.
The agency has documented 352 cases of hepatitis A since November 2016, which have resulted in at least 14 deaths and 264 hospital admittances. Between 2012 and 2016, San Diego had only averaged 28 acute hepatitis A cases per year.
But the numbers keep growing. In the past week alone, 19 new cases and 32 new hospitalizations have been documented. This is more than every single-state hepatitis A outbreak that the US Centers for Disease Control and Prevention have recorded since 1998.
Dr. Rohit Loomba, director of hepatology at the University of California at San Diego observed that the increasing number of cases involving homeless people could be attributed to their living and eating in unsanitary and unsafe conditions.
Loomba said, “My gut feeling is it was a common source where somebody might have given food to a group of homeless individuals.” One hepatitis A got into the homeless community, it could easily have spread through personal contact, Loomba explained.
“They don’t have a clean water supply to wash their hands, and once they have hepatitis A, then they become a source for another person,” he added.
San Diego County has taken steps to try to prevent more people from contracting the disease, including making hand-washing more accessible for homeless people.
However, officials face criticism for addressing the issue too late, when they were aware of the outbreak months ago. Michael McConnell, an advocate for the homeless, said, “I’m no expert on proper responses to public health crises or viral outbreaks, but what I do see a pattern of is a lack of urgency when it involves homeless people, and this really seems to be no different. How hard is it to make sure there’s additional hand-washing stations?”