Hepatitis A Outbreak Triggers Efforts to Clean Up Homeless Encampments Along San Diego River

Although the number of new hepatitis A cases in San Diego appears to be slowing down, on Monday, November 6, 2017, the San Diego Board of Supervisors chose to extend the local public health emergency an additional 2 weeks.

On November 1, 2017, the San Diego Health & Human Services Agency reported that the case count was 544 individuals—up 8 cases from the week before—and the death toll remains at 20. The majority (68.4%) of the individuals infected in this outbreak have required hospitalization.

The outbreak appears to be primarily affecting homeless individuals and illicit drug users. As such, the hepatitis A vaccine has been recommended for these individuals as well as those who are working at homeless service providers and substance treatment agencies, health care providers, and sanitation workers, among others. Health officials have been doggedly working to vaccinate as many at-risk individuals as they can to quell the outbreak. Through these efforts, a whopping 95,188 vaccinations have been administered.

The Los Angeles Times reports that following a “law enforcement crackdown” back in September involving homeless individuals living in the East Village, an announcement was made by San Diego Mayor Kevin Faulconer’s office to “clean up debris from homeless encampments” along the San Diego River. In addition to these clean-up efforts—which have been mainly been focused on areas around Qualcomm Stadium—homeless outreach teams organized by the police department have been dispersed along the river. Team members are delivering vaccinations and offering shelter services to the homeless individuals who are encamped there.

“Our crews will continue to make progress cleaning the city’s portion of the San Diego Riverbed,” director of the environmental services department Mario Sierra reportedly told the news outlet. “Many areas are challenging because of topography, vegetation, and access, but we must do what we can to ensure the river is as free from debris and trash as possible.”

However, some residents feel that vacating the area and cleaning it are just temporary solutions, and that it would take a more large-scale, coordinated effort in order to induce some real environmental change. “Right now, there is just a Band-Aid on the situation,” Tiffany Swiderski, a staff member with the San Diego River Park Foundation, a small nonprofit that has been working on restoring the river, said to the news outlet. “You can’t just do one thing and walk away from it.”

Despite these challenges, the outbreak situation appears to be improving, albeit slowly, according to Wilma Wooten, MD, MPH, public health officer of San Diego County. “We feel it’s getting better,” Dr. Wooten said in a recent presentation to the San Diego Board of Supervisors, covered by another local news outlet.

The county has been providing the public with updated case counts, deaths, and hospitalizations associated with the outbreak, but there has been some confusion as to what the numbers actually mean. According to supervisor Ron Roberts, just because the number of cases is continuing to rise according to the case count reports, that does not necessarily mean that the outbreak has grown. Until cases have been confirmed via genetic testing (which could take weeks), they are not added to the total case count, and, as such, the weekly numbers provided by the county should not be equated to the outbreak’s current severity. This confusion is a call for a clearer way to organize this information, according to Roberts.

In reality, according to Dr. Wooten, the number of daily cases has decreased, going from 2 or more a day to 1 or 2.

To stay up-to-date on the latest case counts regarding the San Diego Hepatitis A Outbreak, be sure to check out the Contagion^® Outbreak Monitor.