San Diego’s hepatitis A update: Case count climbs, but death total holds at 20

Though they continue to see fewer cases and no new deaths have been reported since Oct. 31, San Diego County supervisors on Monday chose to continue the local health emergency status for the region’s ongoing hepatitis A outbreak.

Supervisor Ron Roberts noted that, while he considered the latest hepatitis A report from the county Health and Human Services Agency good news, the emergency won’t be truly over until new-case rates shrink further.

“I hope that day is not too long off,” Roberts said.

It was a decidedly more hopeful tone than was used in early September when the board first declared an emergency, pushing forward to install hand-washing stations and asking cities across the region to help increase vaccination rates and street-level sanitation efforts designed to stop a rising tide of deaths largely among homeless and drug-using residents.

This week, the outbreak’s tally of confirmed and probable cases reached 561, eight more than last week. The outbreak’s death total remained at 20 for the fourth straight week.

Dr. Eric McDonald, chief of the county’s Epidemiology and Immunization Services Branch, said that his department continues to receive reports of one or two new suspected cases each day. That’s far fewer than the 28 cases that were referred during the week of Sept. 3, which seems to be the outbreak’s high point.

“It appears that we are past the peak of cases, but we are still quite a ways from the baseline before the outbreak when there were only a couple of cases per month,” McDonald said. “That is why it is critically important that anyone with a known risk for hepatitis A who is still not vaccinated get vaccinated now.”

The county reported that its ongoing vaccination efforts had reached 5,000 more people throughout the region since Dr. Wilma Wooten, the county’s public health officer, reported crossing the 100,000-shot threshold two weeks ago. Wooten said Monday morning that it’s getting harder and harder to find at-risk residents who haven’t already been vaccinated.

“We are noticing that saturation is increasing,” Wooten said.

The county also appears to be making progress in clearing its backlog of suspected hepatitis A cases. Last week, there were 31 cases awaiting confirmation but this week that number had dropped to 12.

Since the beginning, public health experts have warned that the outbreak has the potential to cross over and become more common among gay men who are at an elevated risk of infection. Such a crossover has been reported in Southeast Michigan where a deadly hepatitis A outbreak has grown nearly as large as San Diego’s. Wooten said that four vaccination clinics at San Diego’s LGBT Center were held between Oct. 18 and Nov. 22. A mobile effort, she added, is expected soon.

“During the first two weeks of December, four mobile van clinics are scheduled at several sites in Hillcrest,” Wooten said.

paul.sisson@sduniontribune.com

Sisson writes for the San Diego Union-Tribune.