Governor declares state of emergency over hepatitis outbreak

LOS ANGELES — Gov. Jerry Brown’s declaration of a state of emergency Oct. 13 due to a widespread hepatitis A outbreak will help secure more vaccinations that are needed to fight the disease, officials said.

The California Department of Public Health has vaccinated more than 80,000 at-risk people in the state with doses mostly received for free from the Center for Disease Control’s 317 program, but will need more, Epidemologist Dr. Gil Chavez of the department’s Center for Infectious Diseases said.

Reports of the disease among the homeless have spiked in recent months in Los Angeles, San Diego and Santa Cruz.

“The federal 317 vaccine program has been a critical element of the response to date, but the vaccine made available through that program is no longer sufficient,” Chavez said, adding that the declaration will allow the health department to purchase more vaccine doses from manufacturers.

An official outbreak of the disease was declared in September in Los Angeles County after two cases of hepatitis A were identified that could not be traced back to San Diego County or Santa Cruz.

The outbreak is worst in San Diego, where 490 cases and 18 deaths have been reported.

Chavez, who spoke with reporters on a teleconference, could not say how many vaccinations would be needed to eradicate the current outbreak or how long it might take to control it.

“The more that we can vaccinate people at risk the quicker the outbreak will be contained. So it’s impossible to put a precise number on months or days,” he said.

Chavez also said a recent move by the Los Angeles County Board of Supervisors to explore adding more public restrooms and hand-washing facilities near homeless encampments could be an effective method of fighting the spread of the disease outside of vaccinations.

“I think there are two keys to preventing hepatitis A, one being vaccination, and two being good access to sanitation,” Chavez said.

Hepatitis A is a highly contagious liver disease that can spread easily through homeless populations because it thrives in unsanitary conditions and is primarily spread through contact with feces via surfaces or sexual contact.

L.A. County sees about 40-60 cases of hepatitis A annually, and although this year’s numbers have not risen above normal, officials raised concerns because of 10 cases reported in homeless patients. Of those 10 cases, five were linked to the outbreaks in San Diego or Santa Cruz and three more cases involved workers at a health facility that could be traced back to the first five.

But the source of two cases in homeless individuals could not be identified, leading to the declaration of a local outbreak.

Between Sept. 19, when the outbreak was announced and Oct. 9, two more “community-acquired” cases have been identified, according to the Department of Public Health website.

Nine of the total 12 patients were hospitalized for some period of time.

Some individuals with hepatitis A may not have any symptoms, while others may suffer mild symptoms over a period of weeks that can be treated with rest, good nutrition and fluids.

Most people recover completely. However, those who have other health issues or weakened immune systems can suffer permanent liver damage and even death.


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