In a follow-up on the hepatitis A outbreak in San Diego County, CA,  health officials report the fourth fatality linked to the outbreak. In addition, the San Diego County Health and Human Services Agency says the outbreak total has grown to 160 cases, resulting in 120 hospitalizations.

Image/Thadius856 via wikimedia commons
Image/Thadius856 via wikimedia commons

Public health investigators are continuing to evaluate cases, but thus far no common food, drink or drug source has been identified as the cause.  Most of those who have become ill are either homeless and/or using illicit drugs.

“We strongly encourage people who are at risk to check with their healthcare providers and get vaccinated for hepatitis A,” said Wilma Wooten, M.D., M.P.H., County public health officer.  “The two best ways to prevent hepatitis A are vaccination and good hand hygiene, which means washing your hands after using a restroom and before preparing or eating meals.”

At least a dozen cases have been reported in people who spent time at one of the following detention facilities: George Bailey, San Diego Central Jail or East Mesa Detention Facility.

Hepatitis A is an infection of the liver caused by a virus. Spread through the fecal-oral route, individuals primarily contract hepatitis A through direct contact with an infected person; however, individuals can also contract the illness indirectly by ingestion of contaminated food or water. If an infected individual does not properly wash his/her hands after using the washroom, the virus can be transmitted through food and beverages prepared by the infected individual.

Hepatitis A can also be spread by having sexual contact or sharing drugs with someone who is infected.

Illness can occur within 15 to 50 days after exposure to the virus, but usually does within 28 to 30 days. Individuals can be infectious one to two weeks before symptoms occur until at least one week after the onset of illness.

Symptoms of hepatitis A may include: tiredness; poor appetite; nausea and vomiting; abdominal pain and fever; followed by dark-colored urine, light-colored stools, and yellowing of eyes and skin several days later. Some people, especially young children, may get hepatitis A infection without noticing any symptoms; however, they are still infectious to others.

The best way to prevent hepatitis A is by getting vaccinated. The hepatitis A vaccine became available in 1995 and is recommended as part of the routine childhood vaccination schedule. However, many adults have not been vaccinated and may be susceptible to the hepatitis A virus.