The Los Angeles County Department of Public Health (Public Health) has declared a local outbreak of hepatitis A (HAV) in Los Angeles County because the most recent new cases appear to be locally acquired.

Hepatitis A outbreaks are currently ongoing in San Diego and Santa Cruz counties. The large majority of cases have occurred in persons who are homeless and/or use illicit drugs (injection and non-injection), with several cases also occurring among people who provide services to the homeless.

Public Health has confirmed 10 total cases of hepatitis A among high-risk individuals (those that are homeless or in institutions that serve the homeless) in Los Angeles County. Of the confirmed cases, four had been in San Diego and one had been in Santa Cruz during their exposure period. Three secondary cases occurred in a healthcare facility in Los Angeles County. The two most recent cases appear to have acquired their infection locally within Los Angeles County.

“Public Health has been proactively preparing for an outbreak for some time and is working diligently to prevent spread in local communities. Our priorities are to keep all our residents both safe and well informed of the situation,” said Jeffrey Gunzenhauser, MD, MPH, Interim Health Officer, Los Angeles County. “Vaccination is the best protection against Hepatitis A. With this in mind, our outreach teams and clinics are offering the free vaccine to persons who are homeless, active drug users, and those who provide services and support to those individuals.”

A person can get hepatitis A if they come into contact with an infected person’s feces through contaminated food or objects. The hepatitis A virus can spread when a person does not properly wash their hands after going to the bathroom or changing diapers. Other modes of transmission include certain sexual practices, sharing equipment related to illicit drug use, and consumption of food or water contaminated with the virus. People who are homeless are at higher risk because they face challenges to maintaining good hygiene.

Physicians are required to report HAV cases to Public Health. HAV causes acute liver disease, which may be severe. It is transmitted by contact with feces from a person who is infected – often through contact with food or water or during sex or other close contact. Signs and symptoms of acute HAV include fever, malaise, dark urine, lack of appetite, nausea, and stomach pain, followed by jaundice. Symptoms generally last for less than 2 months although some persons may have prolonged or more severe illness. Infection can be prevented in close contacts of patients by vaccination or administration of immune globulin within 2-weeks following exposure. If you experience these symptoms, contact your physician.

Although Hepatitis A is very contagious, you can take the following steps to prevent Hepatitis A:

    • Get vaccinated for Hepatitis A
    • Don’t have sex with someone who has Hepatitis A infection
    • Use your own towels, toothbrushes and eating utensils
    • Don’t share food, drinks, or smokes with other people
    • Wash hands with soap and water after using the bathroom, changing diapers, and before preparing, serving or eating food

Public Health continues surveillance for cases and is working closely with healthcare providers and organizations that serve the homeless population to protect the health of patients/clients, staff and the community. Public Health is providing education and vaccination to the homeless and those who work with them, and working with other organizations that provide services for the homeless population to reach this community.

Hepatitis A vaccination is available at Public Health clinics or from your health care provider. County residents may call the LA County Information line at 2-1-1 from any landline or cell phone within the county for referrals to providers offering vaccines at no-cost or a reduced cost. For patients without access to HAV vaccine, Public Health will have vaccine available at its Public Health Centers located throughout the County.

For more information on hepatitis A, visit www.publichealth.lacounty.gov.