Hepatitis A Outbreak in L.A. County
Overview of the Outbreak
Los Angeles County has declared a communitywide outbreak of hepatitis A, a highly contagious viral disease that can lead to lasting liver damage or even death. Although cases of hepatitis A are nothing new in the region, health officials are now expressing alarm both at the prevalence of the disease and who is becoming infected.
Prevalence and Demographics
The total of 165 cases recorded in 2024 was triple the number seen the year before, and the highest in the county in at least a decade, officials say. Seven deaths have been linked to the now-13-month-old outbreak. Historically, hepatitis A infections in L.A. County have largely been identified in homeless people, as limited access to toilets and handwashing facilities can help the disease spread more easily, county health officials say. But this year, most infections have been reported among people who aren’t homeless, and who haven’t recently traveled or used illicit drugs, which are other common risk factors.
Urgent Need for Action
“The ongoing increase in hepatitis A cases signals that quick action is needed to protect public health,” Dr. Muntu Davis, the L.A. County health officer, said in a statement Monday, urging people to get vaccinated against the disease. Over the first three months of this year, 29 cases have been reported, double the total seen during the comparable period last year.
How Hepatitis A is Spread
The highly contagious virus is found in the stool and blood of infected people, and can be contracted by unknowingly ingesting contaminated food and drink. Using drugs with, caring for or having sexual contact with an infected person are also common means of infection, according to the U.S. Centers for Disease Control and Prevention.
Undiagnosed Cases and Wastewater Data
The number of confirmed cases in L.A. County is almost certainly an understatement of the disease’s true prevalence, as infections can go undiagnosed. Even so, this outbreak already far surpasses what had been L.A. County’s most significant hepatitis A outbreak in the last decade, when 87 confirmed cases were reported in 2017. “We definitely think that the outbreak is bigger than the numbers imply,” said Dr. Sharon Balter, director of the Division of Communicable Disease Control and Prevention in L.A. County. The outbreak has also started to make itself apparent in L.A. County wastewater data, Balter said.
Symptoms of Hepatitis A
Symptoms of hepatitis A include fever, fatigue, stomach pain, nausea, a yellowing of the skin or eyes, and dark urine. Among adults, infection usually results in symptoms, with jaundice occurring in more than 70% of patients, according to the CDC. Among children younger than 6, about 70% of infections are asymptomatic.
Vaccine and Prevention
There is a vaccine for hepatitis A, which was recommended by the CDC’s Advisory Committee on Immunization Practices for young children starting in 1996 in areas with the highest rates of disease, and then in 2006 for all children. “The vaccine is very effective,” Gounder said. The CDC recommends all children be vaccinated for hepatitis A at age 1 or 2. Getting vaccinated against hepatitis A has never been required as a condition of entry to California’s kindergartens or child-care centers, however.
Who Should Get Vaccinated
Because of the outbreak, the L.A. County Department of Public Health strongly encourages hepatitis A vaccinations for:
- Any L.A. County resident who has not previously been vaccinated and is seeking protection
- People experiencing homelessness
- People using drugs, including non-injection drugs
Additional Protective Measures
Another way to protect yourself is to regularly wash your hands with soap and water, especially after using the bathroom or before preparing and eating food, Balter said. “If you’re going to use hand sanitizer, really, we’re looking for hand sanitizer that has 60% alcohol or more, and a lot of hand sanitizers don’t,” Balter said, noting that lower-alcohol options don’t always eliminate the virus.
Challenges in Diagnosis and Funding Concerns
Hepatitis A can also be challenging to diagnose because early symptoms might be mistaken for gastroenteritis, or stomach flu, Gounder said. More apparent signs of infection, such as yellow eyes, may emerge later — but possibly only after a test for the virus starts showing as negative. Detecting the scope of the current outbreak through wastewater data has been valuable, officials say. Federal budget cutbacks, however, could affect such services in the future.
Conclusion
The hepatitis A outbreak in L.A. County is a serious public health concern that requires immediate attention and action. With the number of cases on the rise and the potential for severe complications, it is crucial that individuals take steps to protect themselves, including getting vaccinated and practicing good hygiene. The L.A. County Department of Public Health is working to increase awareness and vaccination rates, but the success of these efforts depends on the cooperation and participation of the community.
FAQs
- What is hepatitis A?
Hepatitis A is a highly contagious viral disease that can lead to lasting liver damage or even death. - How is hepatitis A spread?
The virus is found in the stool and blood of infected people and can be contracted by unknowingly ingesting contaminated food and drink, using drugs with, caring for, or having sexual contact with an infected person. - Who should get vaccinated?
The L.A. County Department of Public Health strongly encourages hepatitis A vaccinations for any L.A. County resident who has not previously been vaccinated and is seeking protection, people experiencing homelessness, and people using drugs, including non-injection drugs. - What are the symptoms of hepatitis A?
Symptoms include fever, fatigue, stomach pain, nausea, a yellowing of the skin or eyes, and dark urine. - How can I protect myself?
Get vaccinated, regularly wash your hands with soap and water, especially after using the bathroom or before preparing and eating food, and use hand sanitizer with at least 60% alcohol.