Hepatitis A Outbreak in San Diego: Are You at Risk? What can be done to protect your family?
Given that we are a Los Angeles-based company, the recent outbreak of Hepatitis A in San Diego County that has killed 20 and hospitalized over 350 has our team asking questions about the disease and what precautionary measures can be taken to slow the spread of the virus and reduce the risk of being affected. As the second-largest Hepatitis A outbreak in the US in the last 20 years, this outbreak has become an issue of national concern with the California Governor declaring a State of Emergency. The following is some helpful information on how to stay ahead of the Hepatitis A outbreak.
What is Hepatitis A?
Hepatitis A is a highly contagious infection that impacts the liver. Hepatitis A is primarily spread when someone ingests food or drink that has been contaminated by stool from an infected person. For example, Hepatitis A can spread when a person that is infected with the Hepatitis A virus neglects to wash their hands properly before handling and preparing food or liquids.
The San Diego outbreak is caused by strains of the 1b genetic subtype, which is not normally found in the United States. The outbreak in San Diego County has primarily impacted the homeless population given their inadequate access to sanitation.
Symptoms of Hepatitis A can include fever, fatigue, loss of appetite, nausea, vomiting and abdominal pain. For most people these symptoms usually last less than 2 months, however some people experience them for up to 6 months. Most people fully recover and do not have lasting liver damage.
The Hepatitis A virus can survive in foods or liquids for months. Boiling or cooking food or liquids for more than 1 minute at a temperature greater than 185 degrees Fahrenheit kills the virus, while freezing temperatures do not.
What Is Being Done to Slow the Outbreak?
The State of Emergency issued in California has provided more resources that are being deployed to address three important areas of focus: 1) vaccination, 2) sanitation, and 3) hygiene education.
Vaccination: California officials have distributed tens of thousands of doses of the Hepatitis A vaccine received from the US Centers for Disease Control and Prevention (CDC) and have requested more to continue vaccinating those in need.
Sanitation: The city has begun setting up mobile showering and washing stations complete with sinks for homeless people and at shelters to encourage people to practice safe hygiene. The city has also hired vendors to go throughout the city and clean areas that are likely to be contaminated.
Hygiene Education: Flyers and information leaflets have been prepared and distributed at the local community centers all throughout San Diego County.
No Increased Risk? It is Still a Good Time to Check Your Healthcare Records.
To date, the outbreak has impacted the homeless community and Dr. Gil Chavez, state epidemiologist with the California Department of Public Health has commented to the LA times that “the general population does not have an increased risk of infection at this time.” However, outbreaks like this can, and perhaps should, serve as a strong motivator to check your healthcare records to see if you have been vaccinated and if not to get vaccinated. Also, if you travel outside of the United States, the CDC recommends the Hepatitis A vaccine for most, if not all, travelers. If it has been a while since you were vaccinated for Hepatitis A, you can also check your current immunity status with a simple blood test.
Hepatitis A Vaccine Information
The first Hepatitis A vaccine was licensed in 1995. Given that millions of doses have been administered in the US, there are many options for getting vaccinated — through your primary care physician using insurance, a local clinic that offer Hepatitis A vaccines, and government-operated county clinics for low or no cost. Hepatitis A can be administered as an individual vaccine or as part of a combination with Hepatitis B. Hepatitis A alone is recommended for adults as a two-dose series with the 2nd dose given 6-18 months after the 1st. The combination Hepatitis A/B vaccine is recommended for adults as a 3 dose series with the 2nd dose given 1 month after the 1st and the 3rd dose given 6-18 months after the 1st. On a side note, there currently isn’t a vaccine available to protect against Hepatitis C.
Studies of the duration of the immune response in adults who received the Hepatitis A vaccine as recommended show that antibody response persists in 99% of those studied for at least 6 years. Similar studies in children and adolescents who received two scheduled doses show that antibody response persists in 100% of those studied for at least 10 years post vaccination. However, the total duration of the protective effect in healthy vaccinated individuals is unknown at the time.
Immune Response Testing
There are simple blood tests that can be performed to test your immunity status for several diseases, including the Hepatitis A test and Hepatitis B test. These blood tests, typically know as immunity titers, confirm immunity from prior vaccinations or treated infections. Hepatitis A immunity titer results for previously vaccinated people with active immunity will have a “reactive” total IgG antibody and a “non-reactive” IgM antibody. The Hepatitis A immunity titer requires a standard blood draw and can be performed at thousands of locations in the US. No fasting is required for the test and results are typically available within 2-4 business days after testing.
From our research, the local, state and national governmental agencies have been proactive with their efforts and with a focus on the three primary action areas of vaccination, sanitation and education plan to have the outbreak under control within six to 12 months. We will definitely keep a watchful eye over the situation and post any updates that we find helpful and informative.
While our team has not been directly impacted by the Hepatitis A outbreak in San Diego, most of us have dug up our vaccination records to get a better sense of our immunity profile and suggest that others do as well. Please feel free to contact us with any questions about this information. Stay well!