Hepatitis A has been a significant problem in two metropolitan areas separated by nearly 2,000 miles this year. Of course I’m talking about San Diego County, CA and Detroit, MI and surrounding areas.

Image/National Institute of Diabetes and Digestive and Kidney Diseases
Since the beginning of the year, health officials in San Diego County have reported 421 cases in the local outbreak, in which 16 people have died (~4%). About seven out 10 of the patients required hospitalization for their illness.
Health officials say the majority of people who have contracted hepatitis A are homeless and/or illicit drug users, although some cases have been neither. The outbreak is being spread person-to-person and through contact with a fecally contaminated environment. No common sources of food, beverage or drugs have been identified that have contributed to this outbreak, though investigation is ongoing.
LISTEN: Talking Hepatitis A with Dr Amesh Adalja
In the Detroit area, including Macomb, Oakland, Wayne, and St. Clair counties, the numbers are very similar. According to the latest statistics from the Michigan Department of Health and Human Services (MDHHS), 318 cases have been reported in the past 13 months, including 14 deaths (4.4%). Eighty-five percent of those infected required hospitalization.
In fact, according to a MDHHS spokesperson, since the end of June 2017, 120 cases and four deaths have been recorded.
In addition, like the San Diego outbreak, most cases are reported in the homeless and illicit substance users without substantial numbers of MSM. And based on reported data, the viruses are not genetically identical.
Related:
- Bacteriophage therapy: A remarkable story
- Guinea-worm disease: All cases reported from Chad this year
- Medical marijuana: Few medical schools training students
- Vaccine news: ‘Significant discovery’ in efforts to develop vaccine against Zika, dengue and Hepatitis C viruses
- Brucella warning issued over raw milk, Seven states identified
- Hepatitis A warning issued for patrons of World Famous restaurant in San Diego
- Plague warning: Squirrel tests positive near Palomar Mountain
- GSK shingles vaccine receives FDA approval for adults 50 and over
In both regions, statewide plastic bag bans went into effect this year. These are used by homeless individuals and drug users for storing/packing belongings and for sanitary purposes. It may be they have an unrecognized public sanitation impact.