California declares state of emergency over hepatitis A outbreak

California Governor Edmund G. Brown Jr. declared a state of emergency today to increase the number of adult hepatitis A vaccines needed to contain the state’s ongoing epidemic.

According to Gil Chavez, MD, MPH, deputy director and state epidemiologist at the California Department of Public Health (CDPH) Center for Infectious Diseases, the outbreak is currently affecting San Diego, Santa Cruz and Los Angeles counties. Local health emergencies were previously declared in San Diego on Sept. 1 and in Los Angeles on Sept. 19.

The CDPH has already distributed approximately 80,000 doses of vaccine that were obtained through the federal vaccine program. However, Chavez said during a teleconference today that the vaccine supply made available through the federal vaccine program “is no longer sufficient to address this outbreak.”

With today’s declaration, Chavez said the CDPH can secure funding to immediately purchase additional vaccines from manufactures and distribute them to high-risk individuals in affected areas. According to a CDPH new release, there is an “ample supply” of hepatitis A vaccine for children.

To date, 576 cases, 386 hospitalizations and 18 deaths have been linked to the outbreak since November 2016, according to Chavez. The outbreak is being spread through person-to-person transmission, largely affecting people who are homeless, report illicit drug use, or both. Chavez said the general population is currently not at an increased risk for infection.

“The outbreak is caused by related strains of the same hepatitis A virus genotype 1b, which is not commonly seen in the Americas, but is mostly common in the Mediterranean region and in South Africa,” Chavez said. “This outbreak strain is not known to cause more serious disease than other strains.”

A CDPH representative previously told Infectious Disease News that the overall case count is larger than that of all other hepatitis A outbreaks in California combined over the past 20 years. There were seven hepatitis A outbreaks in the state from 1998 to 2015, totaling 224 cases and one death.

“San Diego, Santa Cruz and Los Angeles health officials have responded quickly and effectively and have taken the necessary steps to identify cases promptly, identify their contacts, vaccinate those at risk, educate the public and improve sanitation,” Chavez said. “Vaccination is the most effective means to prevent additional cases and to control the outbreak.” – by Stephanie Viguers

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