On October 13, 2017, California Governor Edmund Gerald Brown declared a state of emergency due to the recent hepatitis A outbreak in Southern California in order to secure sufficient hepatitis A vaccines, according to a press release from the California Department of Public Health.

To date, the outbreak has primarily impacted California’s homeless populations. “The at-risk populations for Hepatitis A infection are homeless and drug using communities,” said Barbara Garcia, San Francisco Director of Health, in a press release from the San Francisco Department of Health.

The family of hepatitis viruses includes hepatitis A, B, C, D, and E.  Hepatitis A and E only cause acute infections, which the body is capable of fully eliminating, while hepatitis B, C, and D can also cause chronic infections, which can be managed but not cured.

“The most common way for hep. A to be transmitted is that someone has it and then through the improper cleaning of food, it gets passed. So that’s what that fecal to oral usually means… typically you get infected with hepatitis A, and 2-6 weeks after infection you start to show symptoms that are going to mimic all kinds of infections we see. Fever, fatigue, it’s typical of a viral infection,” Urban School science teacher Mary Murphy said.

“The best way to protect yourself from hepatitis A is the two dose vaccine, but that could be something that complicates the problem.  If we’re finding vaccination levels are low, when you have two doses that makes it more challenging,” said Murphy.

In a press release published on October 4th, 2017, the San Francisco Department of Public Health said, “To date the Health Department has distributed 2,500 doses of outbreak prevention hepatitis A vaccine to clinics and community organizations that serve homeless people and drug users. Additional vaccines have been given at primary care clinics, and in homeless shelters and navigation centers. All of these vaccines are provided free of charge to recipients.”

In 2016, The United States Interagency Council on Homelessness estimated that homelessness in California makes up 21.48 percent of total homelessness in the United States. This statistic is of note, as the current hepatitis A outbreaks are being linked to homeless populations in Southern California.

“Usually we see [hepatitis A] in places where hygiene has broken down and there’s lack of sanitation, which is why it’s not that common in the United States and why this outbreak is so concerning and is being linked to the homeless crisis,” said Murphy. “It usually doesn’t kill you, so what’s interesting to me about what’s going on in San Diego is most likely we’re looking at a population of people who have lower overall health. So they already have some underlying complicating factors, and when you add on this hepatitis A infection, it’s pushing their body toward some sort of limit.”