An increase in hepatitis A infections largely among San Diego’s homeless population has prompted the city of San Diego to take more preventive measures.
Public health officials are hoping to avoid an outbreak like the region saw in 2017 by providing additional hand washing stations near homeless encampments. During the 2017 outbreak 20 people died and there were nearly 600 confirmed cases.
There have been 16 hepatitis A infections so far in 2023 and one death. Most of the infections were in people experiencing homelessness. To date the county said two of the cases were connected, but it takes three connected infections to be considered an outbreak. County officials started noticing the small uptick in infections in February and have been tracking it since then. As first reported by Voice of San Diego, on Feb. 15, the county sent a letter ordering the city to deploy additional hand washing stations and restrooms to areas where people experiencing homelessness congregate.
Typically the region sees two-to-three cases per month and eight were reported in March, San Diego County Deputy Public Health Officer Dr. Cameron Kaiser said.
“That’s why we’re taking it seriously — but I also want folks to realize this is still a relatively small number of infections,” Kaiser said. “It just happens to be in a population which is unusually vulnerable and we don't want it to get out of hand.”
Hepatitis A spreads through close contact and fecal matter so good hygiene is key to stopping its spread. In late February, county health officials asked the city of San Diego to add more hand washing stations and portable restrooms to help prevent an outbreak. On March 30 the city notified county officials that it was in the process of adding 10 hand washing stations, all of which were installed by last week. City spokesperson Nicole Darling said no additional restrooms are being added at this time.
“There are existing portable restrooms in key locations identified by the city and those restrooms are secured and maintained by the city,” Darling said in an emailed statement. “Hand washing stations promote hygiene and sanitation and, combined with ongoing vaccination efforts in city shelters, can help prevent the transmission of hepatitis A.”
Before this, approximately 10 hand washing stations were set up throughout the city. The 10 additional ones were placed in downtown, Mission Valley and North Park. San Diego’s Chief Operating officer Eric Dargan told county health officials the city is committed to reducing further spread of the virus.
KPBS visited two of the new hand washing stations on Monday, one did not have any water. Darling said they are serviced daily by a city contractor, United Site Services.
She said from mid-February through March 10 the county has helped vaccinate 292 people in the city against hepatitis A.
“It’s getting hard to get folks vaccinated now because we’ve already vaccinated people who are willing to do so,” Kaiser said. “And of course the local population is very migratory and fluid so we do need to make a more concerted effort to get those folks protected.”
Kaiser said the county health department is working with cities, community providers and the state of California to prevent the spread of hepatitis A. He said outreach teams are regularly going out to provide hygiene and information kits for those living on the streets, shelters and in encampments.
