Los Angeles County has a hepatitis A outbreak based on two “community-acquired” cases that cannot be traced back to San Diego or Santa Cruz, health officials announced this morning.

“We are in the situation of a Hepatitis A outbreak … as of this morning,” Public Health Department Director Barbara Ferrer told the Board of Supervisors.

To date, most cases have been linked to patients who are homeless or drug users, but include workers at a healthcare facility working with those patients, Ferrer said.

In a tweet today, Supervisor Janice Hahn provided advice from public health officials who said “we are early in this outbreak. The best way to prevent spread is for people to get vaccinated.”

Ferrar urged anyone working with high-risk individuals—including health care providers, food-service workers and shelter employees—to get vaccinated.

Children have been routinely vaccinated since 1999, but many adults lack protection against the virus.

“It’s a good idea for everyone to talk to their doctor,” said Dr. Sharon Balter, chief of the department’s communicable disease control program.

However, Balter said the county should focus on the homeless population, where the greatest risk lies. Ferrer agreed.

“The reason we’re particularly concerned (now) is because we have an outbreak in San Diego and we have an outbreak in Santa Cruz” and the contagion is in a “population not easily contained,” Ferrer said.

San Diego health officials said today the outbreak was the second worst in the county with 444 ill, 16 dead and two more being investigated, according to CBS News 8.

The county typically sees about 40-60 cases of hepatitis A annually from the population at large, with a concentration often found among food-service workers. But those patients can be readily tracked and follow-up can be scheduled by phone or email, something that’s not possible when patients are living on the street.

Long Beach health officials are working to inform, educate and vaccinate the at-risk population, include homeless and illicit drug-using individuals and those who closely interact with them, according to City Health Officer Anissa Davis. In addition, staff who work with this population are being trained to avoid infection and protect themselves.

Davis said Long Beach has never had a hepatitis A outbreak as large as the current outbreak in San Diego.

“ln light of the hepatitis A outbreak recently declared in Los Angeles County, the Long Beach Department of Health and Human Services is continuing to work diligently to outreach, educate and offer vaccine to the at risk population of homeless individuals and those who use illicit drugs,” Davis said in a statement. “We continue to educate the community who serve these individuals, city staff and the public at large about hepatitis A and the measures that should be taken to prevent disease.”

The best and most simple way to avoid hepatitis A infection is hand washing, Davis added. 

Hepatitis A is a highly contagious liver disease. Those infected may not have symptoms, while others may suffer mild symptoms over a period of weeks that can be treated with rest, good nutrition and fluids.

“Hepatitis A virus (HAV), is a vaccine-preventable disease transmitted fecal-orally, person-to-person, or through other items such as food,” according to the county DPH website. “Signs and symptoms of acute hepatitis A include fever, malaise, dark urine, anorexia, nausea, and abdominal discomfort, followed by jaundice. Many cases, especially in children, are mild or asymptomatic. Sexual and household contacts of HAV-infected persons are at increased risk for getting the disease.” 

While most people recover completely and don’t have lasting liver damage, according to Ferrer, both those who have other health issues or weakened immune systems can be hospitalized and suffer permanent liver damage.

Keeping hands clean can prevent contagion and part of the county outreach to homeless individuals will include distributing hand sanitizer. An aggressive vaccination campaign countywide is underway.

City News Service contributed to this report.

Stephanie Rivera is the community engagement editor. Reach her at [email protected] or on Twitter at @StephRivera88.