San Diego County health officials have reported forty-two hepatitis A cases since November 2016. This is more than four times the monthly average typically reported.

 Hepatitis A is manifested here as icterus, or jaundice of the conjunctivae and facial skin/CDC
Hepatitis A is manifested here as icterus, or jaundice of the conjunctivae and facial skin/CDC

Thirty-six people were hospitalized and two died from the disease.  Twenty-three cases are men, and the cases range in age from 26 to 72 years, with an average age of 42 years.  Twenty-nine cases have a history of substance abuse, and 27 are homeless.  Five people became ill with hepatitis A after traveling outside the United States.  No common sources of infection have been identified, and investigations are still continuing.

“The County is working closely with the local health community to increase outreach to vulnerable populations to raise awareness and promote hepatitis A vaccination,” said Wilma Wooten, M.D., M.P.H., County public health officer.

“Those at risk are urged to talk to their health care providers and get vaccinated for hepatitis A.”

Hepatitis A is a vaccine-preventable disease. While the hepatitis A vaccine is recommended as part of the routine childhood vaccination schedule, most adults have not been vaccinated and may be susceptible to the hepatitis A virus.

Two doses of hepatitis A vaccine are recommended for:

  • All children (first dose of vaccine between 12 months and 23 months of age, and the second dose six to 18 months later)
  • Travelers to countries that have higher rates of hepatitis A (high-risk areas include parts of Africa and Asia, and moderate risk areas include Central and South America, Eastern Europe, and parts of Asia)
  • Men who have sex with men
  • Users of injection and non-injection illegal drugs
  • Homeless people who are living outdoors
  • Household or sexual contacts of hepatitis A patients
  • People with chronic liver diseases, such as cirrhosis, hepatitis B or hepatitis C
  • Family members or caregivers of a recent adoptee from countries where hepatitis A is common
  • People who are treated with clotting-factor concentrates

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 death.

Risk factors for hepatitis A infection include living with or having sexual contact with someone who has the virus, or sharing injection or non-injection illegal drugs with someone who is infected. The hepatitis A virus can also be transmitted through contaminated food or water.