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State, local concern about Hepatitis A, spread by types of unsanitary behavior

       A new health concern - spread in part by people living on the streets - has become a crisis in San Diego, Calif., is worsening in Colorado and is prodding El Paso County and state health officials to take extra preventive actions.
       It's a disease called Heptatitis A, a contagious liver disease that is passed on by types of unsanitary behavior, but can be contracted by anyone. Symptoms include fatigue, stomach pain and nausea. It can cause liver failure and even death.
       In San Diego County, where the outbreak started in November 2016, a public health emergency has now been declared, with the disease having killed nearly 20
Health officials are concerned about sanitation issues helping spread Hepatitis A. Shown here is a file photo of a transient camp along Fountain Creek, which lacks running water or other facilities for human cleanliness. Dozens of camps like this exist around the city, according to Colorado Springs Police.
Westside Pioneer file photo
people and hospitalized several hundred. A late September CBS News article reports that San Diego sidewalks and benches were being pressure-washed with bleach water, free vaccinations were being broadly offered and dozens of hand- washing stations were being installed where homeless people gather.
       “There's a desperate race against time to stop the Hepatitis A virus from spreading, especially among the area's homeless and drug users,” the CBS article states.
       However, the article quotes San Diego's chief medical officer that “some of these members of the population” have not been cooperating with the remedial efforts and the outbreak could last “for at least another six months.”
       A recent outbreak, though currently less severe, is in Salt Lake City, Utah. Quoting Salt Lake County health officials, a Sept. 28 report by KSL TV states that the area's Hep A is from “the same strain” as that identified in San Diego.
       In Colorado, by the end of August, more than 50 cases had been reported - already more than double the total for 2016, according to a press release from the Colorado Department of Health & Environment (CDPHE).
       “Colorado's Hepatitis A outbreak mirrors similar outbreaks across the country,” said State Epidemiologist Dr. Rachel Herlihy in the release, which adds that most state residents have not been vaccinated but recommends they should be.
       The vaccine can be given to children as young as age 1. However, at least in El Paso County, only Hep B (not A) vaccinations are required for children in schools. (A key difference is that Hep B is not spread through human waste, while Hep A is, according to the website, immunize.org.)
       In a phone interview, Danielle Oller, health information officer for El Paso County Public Health (EPCPH), said that the “high-risk populations are homeless people, gay men and IV [injection-type] drug users.”
       “People experiencing homelessness are high risk for a number of reasons,” Oller said. “They often have underlying health conditions that contribute to more severe illness when exposed to Hepatitis A; they may not have regular access to running water, soap and bathrooms.”
       She noted that in El Paso County this year, there have been 12 cases, which are “higher numbers than last year.”
       One of the victims was a “person experiencing homelessness” who had recently been in San Diego, Oller clarified. In response to that incident, the county “has conducted an extensive investigation to identify any close contacts who may have been exposed. EPCPH has proactively provided Hep A vaccine to those identified contacts at no cost to the individuals. To date, there are no additional cases” [resulting from that incident].
       In addition, Oller said County Health has asked the two largest homeless shelters in Colorado Springs to screen people coming there for Hep A.
       Seeking to perform “proactive outreach,” El Paso and other counties are working with the state to let people know about the risks of Hep A and the vaccine's availability, Oller said. This effort includes “working closely with our clinics within EPCPH to provide vaccines to individuals at risk (more than 200 have been provided this summer),” using social media and printed materials “and making sure medical providers are notified and aware of the increase in cases,” she said.
       For more information, the CDPHE phone is 578-3199; the website is elpasocountyhealth.org.

Westside Pioneer article
(Posted 9/28/17; Community: Ongoing Issues)

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