California Declares Emergency in Fight Against Hepatitis A Outbreak

California health officials will order a big batch of hepatitis A vaccine this week, after Gov. Jerry Brown declared a state of emergency to combat one of the state’s biggest outbreaks of the liver infection in two decades.

Hepatitis A has been racing through homeless populations in San Diego, Los Angeles and Santa Cruz. As of mid-October, 576 people became ill, 386 went to the hospital and 18 people died due to the outbreak.

“Vaccination is the most effective means to prevent additional cases,” said Dr. Gil Chavez, state epidemiologist for the Center for Infectious Diseases at California's Public Health Department.

The state has received 81,000 doses of the vaccine free of charge from the Centers for Disease Control and Prevention, Chavez said, representing a big chunk of the federal government’s total supply for the year. And it’s not enough.

“It's been very clear that our continued requests for additional vaccine is running into the limit of what they can share with California,” Chavez said.

The governor’s emergency proclamation, issued Friday, allows the state to draw money from the general budget to order more vaccines directly from manufacturers.

“We believe that if we procure our own vaccine, we will have more control over the vaccine supply and who gets vaccination,” Chavez said. “We have the capacity to use as much vaccine as we can get our hands on.”

Hepatitis A is a viral infection that attacks the liver, causing fever, nausea and abdominal discomfort, followed by yellowing of the skin. It is typically spread when an infected person doesn’t wash their hands after using the bathroom, then touches food or public surfaces.

It has spread quickly among drug users and in crowded homeless communities that lack public restrooms and sinks, growing into the largest person-to-person hepatitis A outbreak in the state since a vaccine was developed 22 years ago, according to the governor’s emergency proclamation.

Several counties, including Sacramento, Orange and San Francisco, have been pro-actively offering vaccinations at shelters, drop-in centers, food pantries and tent encampments.

“We do not have an outbreak of hepatitis A in San Francisco and we want to keep it that way,” said Dr. Tomas Aragon, the city’s health officer. “The best way to prevent that is by vaccinating as many people as we can who are at risk.”

There is no increased risk of infection in the general population, Chavez said. The state usually sees about 150 cases of hepatitis A per year, mainly among people who travel to, or are visiting from, countries where the virus is common.

The hep A vaccine has been routinely recommended for children in California since 1999, meaning most kids and teens are protected against the disease. Otherwise, good sanitation and thorough hand-washing is the best protection.

Though the hep A vaccine is normally administered in two doses that are six months apart, Chavez said even getting only the first dose can prevent infection for up to 20 years.

“The first dose is one that gives you a very, very high level of immunity,” he said. “We believe that if we are able to get only one dose in people that that will be sufficient to contain the outbreak.”