Hepatitis A on the rise in California

By Kevin Martinez
4 July 2017

A fourth person died last month in San Diego, California due to a Hepatitis A outbreak, which has infected over 196 people, according to the County Health and Human Services Agency. Over 142 people have been hospitalized and no source of the disease has been identified as of this writing. Those who have succumbed to the disease are either homeless, using illicit drugs, or both.

Hepatitis A is a liver infection caused by the Hepatitis A (HAV) virus. It is highly contagious and can be spread by people sharing food or touching an object that someone with HAV has handled. It can cause liver disease, which can last for a few weeks or months. In serious cases, it can be fatal.

Symptoms of HAV include jaundice (yellowy eyes and skin), loss of appetite, fatigue, nausea, stomach pains, dark urine, and diarrhea.

The disease is easily preventable with proper hygiene especially washing one’s hands after using the bathroom. Given the atrocious living conditions forced on the homeless in California and the United States, diseases once thought eradicated or at least lessened are now making a comeback.

Those who have been exposed to HAV can develop symptoms up to 50 days after exposure. The disease can still be prevented if someone gets immunized within two weeks of exposure.

San Diego first began to see a rise in Hepatitis A last November and by the first press release in April 2017, 42 people had been diagnosed with the disease. An outreach campaign by the local government, including vaccination efforts and distribution of educational flyers, has failed to stop the disease from spreading.

The total caseload in the first half of 2017 was already 700 percent higher than the county’s yearly average since 2011. The hospitalized are overwhelmingly from the city’s homeless population.

The county has pledged to install hand-washing stations in areas of the city where there is a high concentration of homeless people. Outreach teams also have been distributing kits with soap, small bottles of water, and hand sanitizer. The city has administered roughly 4,200 vaccinations since the start of the outbreak.

San Diego County health experts have yet to determine exactly what is causing the outbreak, which usually can be traced to tainted food products. Some have theorized the state’s recent ban on plastic bags has forced homeless people to use the same bags in their possession and transmit the disease more easily, but that is only one theory.

Many advocates for the homeless point out there are little or no portable toilets or places that provide food and showers, which are open 24 hours a day. The city has used the pretext of drug use and illegal activity as a way of cracking down on unattended properties, like portable toilets and showers. As a result, diseases can now spread much more quickly.

The outbreak of HAV is not confined to San Diego. In Santa Cruz, the County Health Services Agency reported at least nine confirmed cases of HAV since last April. The county usually only reports cases of HAV once or twice a year. Just like in San Diego, those who have caught the disease are homeless, or using illicit drugs, or both.

There have also been serious HAV outbreaks in Hawaii due to imported scallops from the Philippines. Over 290 people were sickened, mostly in Oahu, and many more would have gotten sick had the rate of infection not slowed due to the embargo on the contaminated scallops.

In September of last year, the Centers for Disease Control (CDC) announced it was investigating a nationwide outbreak of the disease in not only California, but also Wisconsin, Oregon, Arkansas, New York, Virginia, West Virginia, Maryland, and North Carolina.

As a direct result of the social crisis in America, diseases once thought to be a thing of the past have returned. In 1989, the CDC reported 40,000 cases of HAV, declining to less than 5,000 cases per year today. The enormous decline in living standards since 1989 and the combined bipartisan attacks on public health means these numbers will go up again to their previous heights if not worse.

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