Hepatitis A Outbreaks in Homeless and Illicit Drug User Populations in California
San Diego, Santa Cruz, and Los Angeles Counties are experiencing Hepatitis A outbreaks primarily in their homeless and illicit drug user populations. San Diego County currently has 544 cases of Hepatitis A, including 20 deaths, Santa Cruz County has reported 76, and Los Angeles County has reported 15 cases.
 
For more information on the multi-jurisdiction outbreak:
 
Orange County has not had an outbreak or local spread of Hepatitis A, but has had two cases of Hepatitis A associated with outbreaks in other counties. Both cases have since recovered and there is no evidence of transmission to others from these cases. Additional cases of Hepatitis A in Orange County associated with these events may occur.
Background on Hepatitis A
Hepatitis A is a contagious virus that can cause inflammation of the liver. Symptoms of Hepatitis A infection may include jaundice (yellow eyes or skin), abdominal pain, dark urine, pale (light-colored) stool, extreme tiredness, loss of appetite, fever, nausea, vomiting, or diarrhea. Some people, especially children, do not have any symptoms. Illness occurs about one month (range, 15 to 50 days) after exposure to the virus.

Hepatitis A is usually spread when the Hepatitis A virus is taken in by mouth through contact with objects, food or drinks that are contaminated by feces (stool) from an infected person, or through sexual contact with an infected person
Recommendations
  • Given the outbreaks currently occurring in multiple counties in California, Orange County Health Care Agency (OCHCA) is recommending Hepatitis A vaccine for all persons who are homeless or use illicit drugs in Orange County aged one (1) year or older.
  • Hepatitis A vaccine is typically given in two doses – an initial shot followed by another shot at least six months later.

  • The California Department of Public Health recommends considering HAV vaccination for persons working with the at-risk population in counties such as San Diego that have active local outbreaks. Orange County does not currently have an outbreak of Hepatitis A; persons working with the homeless or illicit drug users in Orange County are currently at minimal risk. If you have questions or concerns about your level of risk or desire vaccination, please speak to your medical provider.

  • Routine Hepatitis A vaccination of the general population should continue for all children at one year of age, as well as persons with high risk conditions or behaviors including: illicit drug users, men who have sex with men, and persons who work or travel to countries with high rates of Hepatitis A.

  • Persons with symptoms of Hepatitis A such as jaundice, dark urine or pale stool, should seek medical care as soon as possible. Suspect or confirmed Hepatitis A patients should be reported promptly to Orange County Public Health Epidemiology by phone at (714) 834-8180 or by fax at (714) 564-4050.

  • Frequent handwashing, especially after using the bathroom or changing a diaper, and before preparing food can help prevent the spread of Hepatitis A.

For general questions about Hepatitis A and to download a variety of educational materials please see www.ochealthinfo.com/OCHepA . To find out where Hepatitis A vaccine clinics are being held, please contact the OCHCA Health Referral Line at (800) 564-8448.
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