The County of San Diego Health and Human Services Agency on Tuesday increased the total number of deaths related to an outbreak of hepatitis A in the county to 11, marking three new deaths since July 28.
The number of reported cases jumped from 275 to 333 over the same time period. The amount of hospitalizations associated with the outbreak also increased from 194 to 232. Approximately 70 percent of those affected by the outbreak have either been homeless, an illicit drug user or both. An investigation into the source of the outbreak is ongoing.
"The outbreak is still an enigma. We have not been able to identify a particular food, beverage or any other product as being the source of the outbreak," said Wilma Wooten, MD, the county's public health officer and director of public health services, according to The San Diego Union-Tribune.
Symptoms of hepatitis A infection include abdominal pain, a low-grade fever, nausea, fatigue and jaundice. The virus is highly transmissible and is most often spread via contact with fecal matter from an infected individual, which can contaminate food and water. Good hygiene practices that can help prevent the spread of infection are more difficult for individuals living on city streets.
Bob McElroy, president and CEO of the Alpha Project, a San Diego nonprofit that works with the city's homeless population, said the rising death toll highlights the importance of a current proposal to provide temporary tent-based housing for an estimated 5,621 people. The housing would also allow for coordinated sanitation and vaccination efforts, according to the Union-Tribune.
"I'm afraid that this number of deaths may be just the tip of the iceberg unless we get some type of central intake facility going soon so that we can centralize the response," Mr. McElroy told the Union-Tribune.
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