Outbreaks of Hepatitis A virus (HAV) infection have been identified in homeless and illicit drug using populations in multiple California counties. San Diego County has identified 516 cases of HAV infection, including 19 deaths, Santa Cruz County has had 73 cases, and Los Angeles County has had 14 cases. This week, the California Department of Public Health (CDPH) declared a statewide hepatitis A state of emergency. CDPH is advising that HAV vaccine be prioritized to communities that are experiencing active local spread of HAV.
Orange County has not had an outbreak or local spread of HAV, but has had cases associated with outbreaks in other counties. One Orange County case occurred in a homeless resident who developed HAV in July after travel to San Diego. A second resident who developed illness in August had no history of homelessness, illicit drug use, or travel to San Diego, but was linked to the outbreak by CDC genotype testing. Additional cases in Orange County may occur.