Sixteen deaths, 421 people infected — that is the growing toll of San Diego County’s outbreak of hepatitis A that has hit the homeless population especially hard.
Hepatitis A is a highly contagious liver disease. It is spread when someone ingests food or water that has been contaminated with the feces of an infected person.
It can also be spread through sexual contact.
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Dr. Hai Shao, infectious disease specialist at Sharp Chula Vista Medical Center, said people can inadvertently spread the virus, because the incubation period can be 28 days long.
"So they may not know that they’re infected," Shao said. "But the virus could be shed in the feces, and get on their hands after using the bathroom."
Symptoms, when they do emerge, can include fever, diarrhea and jaundice.
It turns out that proper hand washing can go a long way toward preventing hepatitis A transmission. That is why San Diego County health officials have set up dozens of handwashing stations in areas where the homeless congregate.
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They have also launched a campaign to vaccinate people at risk for the disease. So far, some 19,000 people have been inoculated since the outbreak began earlier this year.
The majority of the hepatitis A cases in San Diego have been among people who are homeless.
Shao believes the general public is not at high risk.
"I would say as long as you practice common sense and good hand hygiene, your chance of being infected with hepatitis A is low," he said.
Two doses of the hepatitis A vaccine are recommended in early childhood.
Federal health officials say since the vaccine became available in 1995, hepatitis A rates have declined by 95 percent.