An outbreak of Hepatitis A among San Diego's population has the potential to spread to Los Angeles, prompting L.A. County to institute preventive measures.
Hepatitis A is a contagious disease that is spread through direct contact with an infected person, or through the ingestion of food contaminated with feces from an infected person. The disease primarily affects homeless populations and individuals using illicit drugs, but those affected mostly recover with rest and sufficient fluids, with typically few hospitalizations or fatalities.
The San Diego outbreak began in November 2016, with the number of likely and confirmed cases beginning to increase in March. As of Sept. 12, San Diego County reported 421 cases related to the outbreak, with 292 hospitalizations and 16 deaths. Los Angeles County, which has one of the largest homeless populations in the nation, is encouraging its homeless population and illicit drug users to get the Hepatitis A vaccine to prevent an outbreak in the city.
Takeshi Saito, an assistant professor of medicine at the Keck School of Medicine, said that there is probably no immediate danger of an outbreak in Los Angeles. Still, because infected people may take a month to show symptoms, they may be unaware that they have contracted the disease. During this time, he said that it's "very possible because of the physical proximity" for infected people to spread the disease as they travel between San Diego and Los Angeles.
The LAC+USC Medical Center, where Saito is an attending physician, recently treated a case of acute Hepatitis A. Saito said that the patient denied any recent travel to San Diego, and that the case is in line with the one or two cases the hospital treats each year. "If the San Diego story is coming up to Los Angeles, we anticipate seeing more and more," he said.
Saito emphasized that not only homeless populations are at risk. In 2013, frozen berries sold by Costco were linked to the virus, causing at least 11 cases on the west coast. "It can be anyone," Saito said.
Jeffrey Kahn, an Associate Professor Clinical Medicine at Keck, said that a common misconception about Hepatitis A is that "it's a disease of dirty people."
"It's often passed to people who are going to even a fancy restaurant where a food handler happens to be infected," Kahn said.
Contracting the disease may also occur through contact with others, Kahn cautioned. "If you have 10 students living in a house together, if one student gets infected there's a good chance others will as well," he said. "If people would just wash their hands after using the restroom, that would alleviate a huge problem."
According to Sarah Van Orman, the Chief Student Health Officer at USC, "There is no outbreak reported in LA county and the risk to the USC community is extremely low," but that USC campus health offices closely monitor outbreaks of communicable diseases in the community.
Still, Saito suggested that USC announce the availability of the vaccine, as universities in San Diego have done.
"That seems to be a good idea that this university has a clear idea of what to do for prevention," Saito said.