Despite health officials following
protocol, one of the largest hepatitis A outbreaks the country has experienced
in decades continues to worsen in San Diego. So far, at least 481 people have
been infected and 17 have died of the infection in the last year just in this
particular outbreak. In Santa Cruz and Los Angeles counties, another 88 cases
have been identified. This outbreak is unusual for the USA in that it has been
attributed to a lack of basic hygiene and sanitation, with Homeless
populations especially impacted, while
Hepatitis A is most commonly transmitted through contaminated food. In 2003, 935
people in multiple states were infected with hepatitis A by eating contaminated
green onions at a restaurant, and there were no fatalities. It was the largest
outbreak since 1998, according to the CDC.
The model for public health officials addressing hepatitis A is to first determine how hepatitis is being spread, vaccinate the at-risk community and make special efforts to improve sanitary and hygienic practices to eliminate fecal contamination. Over the summer, San Diego’s public health officials have shifted focus to sanitation, including hand washing and street cleaning. Streets where nearly 85 percent of confirmed cases were located are being cleaned, pressure washed with bleach in an effort to sanitize any feces, blood, bodily fluids or contaminated surfaces. In September, portable hand-washing stations were delivered in locations where homeless residents tend to congregate. According to Dr. Jeffrey Engel, executive director of the Council of State and Territorial Epidemiologists, these sanitation efforts might not be enough. "I can tell you that washing the door knobs is not going to do it," Engel said. "This is more about human behavior than anything else." This hepatitis A outbreak is complicated by the fact that eliminating a food source will not stop its spread. "You're starting out with a very difficult patient population; probably the most challenging population we have," Engel said. "They don't have any address, they're hard to find and it's a population that's associated with substance abuse and mental illness." I will be looking for future updates to see how effective the sanitation efforts prove to be slowing the spread of hepatitis A.
The model for public health officials addressing hepatitis A is to first determine how hepatitis is being spread, vaccinate the at-risk community and make special efforts to improve sanitary and hygienic practices to eliminate fecal contamination. Over the summer, San Diego’s public health officials have shifted focus to sanitation, including hand washing and street cleaning. Streets where nearly 85 percent of confirmed cases were located are being cleaned, pressure washed with bleach in an effort to sanitize any feces, blood, bodily fluids or contaminated surfaces. In September, portable hand-washing stations were delivered in locations where homeless residents tend to congregate. According to Dr. Jeffrey Engel, executive director of the Council of State and Territorial Epidemiologists, these sanitation efforts might not be enough. "I can tell you that washing the door knobs is not going to do it," Engel said. "This is more about human behavior than anything else." This hepatitis A outbreak is complicated by the fact that eliminating a food source will not stop its spread. "You're starting out with a very difficult patient population; probably the most challenging population we have," Engel said. "They don't have any address, they're hard to find and it's a population that's associated with substance abuse and mental illness." I will be looking for future updates to see how effective the sanitation efforts prove to be slowing the spread of hepatitis A.
- Hannah
Source: San Diego Union-Tribune http://www.sandiegouniontribune.com/news/hepatitis-crisis/sd-me-hepatitis-prevention-20171006-story.html
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