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Hepatitis A spreading among Los Angeles homeless population, health officials say

A woman bends over to rinse her hair in a jet of water from a hydrant.
A homeless woman washes up at a fire hydrant near her encampment along south Lemon Street in downtown Los Angeles.
(Genaro Molina / Los Angeles Times)
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The Los Angeles County Department of Public Health is investigating an outbreak of the highly contagious liver disease hepatitis A among its homeless population.

Health officials said five cases of hepatitis A have been reported since mid-March among people experiencing homelessness. The virus, which can spread among people even before they have symptoms, can be found in the stool and blood of those who have been infected. Symptoms include fever, nausea, vomiting, abdominal pain, diarrhea, dark urine and yellow eyes and skin.

“Individuals that are unhoused are at higher risk for contracting hepatitis A infection because they often have limited access to hand-washing and toileting facilities,” the department wrote in a statement.

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An ailing inmate worker in the kitchen at Men’s Central Jail unwittingly exposed thousands of detainees to hepatitis A before medical staff discovered what was wrong with him, triggering a vaccination campaign last year.

Feb. 16, 2024

The health department said it was offering free hepatitis A vaccines to people experiencing homelessness in encampments and interim housing sites where there is a risk of potential exposure. The vaccine can be given to people even after they’ve been exposed to protect against developing the infection.

The department said it was working closely with healthcare and homeless services providers to increase awareness about the virus and growing risks. It urged residents to get vaccinated and to wash their hands after using the bathroom.

California’s last known hepatitis A outbreak occurred between 2016 and 2018, mostly among people experiencing homelessness or people using drugs in settings with limited sanitation.

When the outbreak was contained in 2018, the state reported 708 cases. More than 60% of those infected required hospitalization, and at least 21 people died, according to the U.S. Centers for Disease Control and Prevention.

Last year, a similar outbreak occurred among the homeless population in Portland, Maine. Health officials there recorded at least 18 confirmed cases of hepatitis A in the city’s homeless population.

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So far, three states have ongoing hepatitis A outbreaks.

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