Monterey County declares Hep A outbreak among homeless

UPDATE 2/6/2017 6 pm: As one county reports its Hepatitis A outbreak is over, another says it is just beginning. Monterey County health leaders say – it’s becoming a growing problem.

During any given year, the department gets reports of maybe one or two Hepatitis A cases. Right now, they’re sitting at ten since October 2017. Nine of the patients are homeless. As for the tenth, health officials will only say that person has the same strain as the outbreak we’re seeing across the state.

“We’ve reached a point where we’ve had a significantly higher number of Hepatitis A cases among the homeless population and transmission continues among the homeless population,” said Monterey County Health Officer Dr. Ed Moreno. “So for that reason, we’re working closely with the California Department of Public Health and decided to declare an outbreak for the homeless population of Monterey County.”

Homeless people are at the highest risk of getting infected. People who work directly with the homeless, such as health care and homeless providers could also see an increased risk. Health officials say everyone should be on alert.

“People need to keep in mind if they haven’t been vaccinated against Hepatitis A, they are still susceptible to getting Hepatitis A,” Moreno said. “I would say a person who is not homeless or works with homeless individuals still needs to take precautions to make sure they don’t contaminate themselves.”

The health department is pushing vaccination, education, cleanliness and disinfection to stop the outbreak. They say people need to wash their hands with soap and water after using the bathroom, and that hand sanitizers may not be effective in killing the virus.

Health officials are also encouraging businesses with public bathrooms to use chlorine diluted with water to get rid of Hepatitis A.

The maintenance supervisor of Dorothy’s Place and the Chinatown Health Services Center said they use a commercial sanitizer to disinfect their facilities.

‘I’ve done trainings with our employees and volunteers on how to properly use it, so I’m confident that we’re pretty safe in our buildings,” Javier Rodriguez said.

We also checked in with Salinas Public Works, who is in charge with keeping public restrooms clean.

“When they’re related to a facility, we have a janitorial service that comes in every day and wipes them down with chlorine and Lysol and gets them all nice for the public in the morning,” said Don Reynolds, acting public works for the City of Salinas. “So that’s city hall, that’s the Steinbeck Library, any of our public facilities where restrooms are available to the general public.”

The city has park maintenance staff that is in charge of cleaning the 20 or so restrooms at public parks across the city.

The outbreak is considered over when a certain amount of time passes and there aren’t any new cases reported. According to Public Works, that could be up to 100 days.

Santa Cruz County has declared an end to its Hepatitis A outbreak. Overall, there were 76 confirmed cases and one death.

ORIGINAL POST: Health officials in Monterey County said the Hepatitis A virus has now reached outbreak levels.

Since the start of 2017, health departments in San Diego and Santa Cruz have been investigating hep A outbreaks in people who are homeless or those who use illicit drugs. Since October, nine homeless people have been diagnosed with hep A in Monterey County.

“These individuals did not travel outside of Monterey County so are assumed to have become ill due to transmission within the homeless and illegal drug use communities in Monterey County,” said Monterey County health officials.

Hep A is a disease of the liver. Symptoms of Hep A include fever, tiredness, nausea, vomiting, loss of appetite, stomach pain, yellowing of the skin, dark urine, pale stools, and diarrhea.

Monterey County’s Health Officer, Dr. Edward Moreno, stated, “Despite our efforts, hepatitis A continues to spread among the at-risk population. To stop the outbreak, we must as a community collectively increase our efforts to end transmission of the hepatitis A virus.”

The health department recommends 4 basic strategies to prevent transmission of hep A:

Vaccination. The Monterey County Health Department recommends that all providers serving the homeless, injection drug users, incarcerated individuals, international travelers, and men who have sex with men actively seek opportunities to vaccinate their patients in these high-risk groups. Individuals who work closely with homeless people and illicit drug users on a frequent and ongoing basis, such as those who work or volunteer at homeless service agencies and syringe exchange programs, as well as health care workers who provide ongoing direct medical care to these populations, should also consider vaccination against hepatitis A at this time. Education. Health care providers, businesses, and community service providers should inform their at-risk clients and patients about the spread of hepatitis A in Monterey County and how they can protect themselves. Easy-to-read handouts in English and Spanish about hepatitis A are available for download at www.mtyhd.org/hepA. Increased Hand Hygiene. Everyone can play a role in addressing this public health issue by stressing the importance of hand-washing with soap and warm water after using the bathroom and before preparing, serving, or eating food. Hand sanitizers do not replace the need for hand washing. Disinfection. Businesses with public restrooms should increase the frequency of cleaning AND disinfecting bathroom surfaces. For heavily used restrooms, clean and then disinfect multiple times per day. Use a chlorine-based disinfectant (bleach) with a ratio of 1 and 2/3 cup of bleach to one gallon of water. Remind employees of the importance of wearing disposable gloves and hand-washing with soap and warm water after cleaning restrooms. Additional guidance is available on the Health Department’s website at www.mtyhd.org/hepA.