Hepatitis A

San Diego Hepatitis A Outbreak, 2017

Since early 2017, the Public Health Services Division, in the County of San Diego Health and Human Services Agency, has been investigating a local Hepatitis A outbreak. The majority of people who have contracted hepatitis A are homeless and/or illicit drug users, although some cases have been neither.  The outbreak is being spread person-to-person and through contact with a fecally contaminated environment.  No common sources of food, beverage or drugs have been identified that have contributed to this outbreak, though investigation is ongoing.  The Centers for Disease Control and Prevention (CDC) notes that person-to-person transmission through close contact is the primary way people get hepatitis A in the United States.

Vaccination efforts are being implemented in targeted locations by County staff and in collaboration with health care partners. Health providers are asked to inform the Epidemiology Program if they have a patient suspected to have the hepatitis A infection, before the patient leaves the emergency department or provider’s office (see contact number below). 

On September 1, 2017, the San Diego County Public Health Officer declared a local public health emergency due to the ongoing hepatitis A virus (HAV) outbreak in the county. The County Board of Supervisors ratified this declaration on September 6, 2017 and again on September 12, 2017. The declaration shall be ratified every two weeks by the County Board of Supervisors until the declaration is rescinded.

For information and resources, please click on the links below:

The table below will provide a weekly update of total cases, deaths, and hospitalizations.  Following this update is information about hepatitis A to educate the community and help prevent the continual spread of this viral infection.

San Diego County Hepatitis A Outbreak Cases and Deaths as of September 19, 2017*
*Table will be updated weekly each Tuesday

Cases Deaths Hospitalizations
444 16 (3.6%) 305 (69%)

Please note: Table does not include all reported hepatitis A cases in the county; only those that are local-outbreak-related. Also, data are provisional and subject to change.


What is Hepatitis A?

Hepatitis A is a liver infection caused by the Hepatitis A virus (HAV). HAV is highly contagious. It can cause liver disease, lasting a few weeks to a serious illness lasting months. In some cases, people can die.

Take CDC's Hepatitis Risk Assessment and get a personalized report in 5 minutes.

How Is It Transmitted?

HAV is usually transmitted by:

  • Touching objects or eating food that someone with HAV infection handled.
  • Having sex with someone who has a HAV infection.

What Are the Symptoms?

HAV does not always cause symptoms. Some people get HAV and have no symptoms of the diseases. Adults are more likely to have symptoms than children.

Symptoms include fever, fatigue, nausea, loss of appetite, yellowing of the eyes (jaundice), stomach pain, vomiting, dark urine, pale stools, and diarrhea.

Hepatitis A can be prevented with a safe and effective vaccine.

Who Should Get the HAV Vaccine?

  • Travelers to countries with high or medium rates of HAV.
  • Men who have sex with men.
  • Users of injection and non-injection illegal drugs.
  • Individuals with chronic liver disease, such as cirrhosis, hepatitis B, or hepatitis C.
  • Persons with clotting factor disorders.
  • Individuals who are homeless.
  • Individuals who work with homeless and/or users of illegal drugs.
  • Food handlers
  • Anyone who is concerned about HAV exposure and wants to be immune.

Note: individuals with chronic liver disease (i.e., cirrhosis and hepatitis C) may not be at increased risk of getting HAV infections but are at increased risk of having poor outcomes if they are infected with HAV.

How Can HAV Be Prevented?

  • Get two shots of the HAV vaccine. The vaccine may be given as a twin vaccine against both Hepatitis A and B.
  • Don’t have sex with someone who has HAV infection.
  • Use your own towels, toothbrushes, and eating utensils.
  • Don’t share food, drinks, or smokes with other people.

Where Can I Get Vaccinated?

  • Call 2-1-1 to find a community clinic near you to request the HAV vaccine.
  • Click here to see a list of community health centers.
  • Click here for a list of Public Health Center Immunization Clinic sites.

What If I Need Additional Assistance or Treatment?

Please contact your local healthcare provider.



  • California AIDS, STD and Hepatitis Hotline—800-367-AIDS (2437)
  • (24 hours/day, 7 days/week)
  • Centers for Disease Control and Prevention (CDC) Information Hotline—
    800-CDC-INFO (232-4636) (24 hours/day, 7 days/week)

Educational Information


News Stories

CAHAN Alerts


Hygiene Kits

As part of its Hepatitis A infection prevention efforts, the County of San Diego Health and Human Services Agency has produced hygiene kits (pictured right). These kits contain hand sanitizer (as available), cleansing wipes, bottled water, an informational flyer, and a waste bag. The kits are being provided to community partners that serve vulnerable populations, such as homeless persons and illicit drug users. When distributing kits to clients, community partners are encouraged to also recommend the Hepatitis A vaccination.

Hep A


Hepatitis A Tent Cards

Wallet-sized Hepatitis A tent cards are available through the County of San Diego HHSA Immunizations Program and include information about the Hepatitis A infection, symptoms, and prevention as well as contact information for the Nurse's Line, getting the Hepatitis A vaccine, and a blank space to record vaccination status. 

For more information, contact the Epidemiology Program at 619-692-8499 or send us an e-mail.