At a special meeting Tuesday, the San Diego County Board of Supervisors ratified a local health emergency declared for the ongoing hepatitis A outbreak in the county.

The emergency was declared on Sept. 1 by the County public health officer to raise awareness of the outbreak and allow the County to potentially ask for mutual aid if necessary. Board action was required to extend the local health emergency beyond its initial seven-day period.

The meeting included a presentation by public health officials and public comments. View video of the entire meeting.

Since Nov. 22, 2016, 15 people have died, all of whom had underlying medical conditions.  Additionally, 279 of the 398 reported cases have been hospitalized. Approximately 65 percent of the cases have been among people who are homeless, use illicit drugs or a combination of those two factors.

The County has implemented a three-part strategy to combat the outbreak that includes immunization, sanitation and education efforts.

So far the County has immunized over 19,000 people, including approximately 7,300 to the at-risk population. There have been 256 mass vaccination events and 109 “foot teams” of public health nurses have gone out into areas with heavy homeless populations to offer vaccinations.

The public health officer has also issued new recommendations that people who handle food and health care workers get vaccinated.

Last week, 40 handwashing stations were placed in areas around the City of San Diego with high concentrations of homeless people. Steps are also being taken to sanitize areas where significant numbers of homeless people are living. Sanitation may help decrease the hepatitis A virus in the environment which may lower the likelihood of the virus spreading.

County staff have also distributed over 2,400 hygiene kits to individuals. The kits contain water, non-alcohol hand sanitizer, cleaning wipes, clinic location information and plastic bags.

An education ad campaign was started in mid-August in trolleys and bus stations in the City of San Diego. That campaign will be expanding into North County. Public Health has also made over 50 presentations to local community partners, providing them with prevention information and educational materials on vaccinations and proper hand washing hygiene.

Hepatitis A is most commonly spread person-to-person through the fecal-oral route. Symptoms of hepatitis A include jaundice (yellowing of the skin and eyes), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, and light-colored stools.  Symptoms usually appear over a number of days and last less than two months.  However, some people can be ill for as long as six months. Hepatitis A can sometimes cause liver failure and even death.

For general information on hepatitis A, visit the HHSA hepatitis website where data are updated routinely. A hepatitis A fact sheet is also available.