A state of emergency has been declared in San Diego County, California, on Friday 1 September, where an outbreak of Hepatitis A has killed fifteen people since November 2016 and hospitalised around four hundred more. The liver disease, which is spread through feaces, is not usually fatal in healthy individuals, but has caused a high number of fatalities in recent Californian outbreaks, when it has become established among populations of homeless people, who are often malnourished and/or immunocomprimised, making them particularly vulnerable. The declaration enebles San Diego to request assistance from the state authorities in California, and to enforce new sanitation measures. The city intends to provide new washing facilities in areas with high concentrations of homeless people, and to aquire specialist high-pressure cleaning equipment for removing blood and other bodily fluids from contaminated surfaces (measures that proved effectinve during a similar outbreak in Los Angeles), on top of a vaccination and education program already in place. These measures are likely to be adopted by neighbouring measures in South California in the near future.
A contractor installing a publich wash station in San Diego on 1 September 2017. Eduardo Contreras/The San Diego Union-Tribune/AP.
Hepatitis A is cuased by Hepatovirus A, a form of Picornavirales, non-enveloped isohedral RNA viruses about 30 nanometers in diameter, which are known to infect a variety of Vertebrates, Insects, Plants and Algae.
Electron microgaph of a Hepatovirus A Virus. Centers for Disease Control and Prevention/Wikimedia Commons.
Hepatitis A infects the Human liver, and often causes no symptoms in young, healthy individuals (though these can still pass the disease on). Individuals that do develop symptoms will typically suffer fever, nausea, vomiting, jaundice and abdominal pain, which can last for up to about eight weeks. Weaker individuals may suffer repeated bouts of symptoms, and in the worst cases acute liver failure, which is fatal without extreme medical intervention, such as a liver transplant.
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