San Diego’s huge outbreak of hepatitis A ― a preventable but deadly virus that is spread through contact with human feces ― captured national media attention in September. The city began washing streets it believed were contributing to the problem with bleach and initiated a local vaccination campaign among the communities most affected. Soon, it was out of the national conversation.
But similar outbreaks have continued throughout the country, still largely among the homeless and illicit drug-using populations who are most vulnerable to the disease, with few national headlines in sight. Meanwhile, the Morbidity and Mortality Weekly Report out of the Centers for Disease Control and Prevention ― which the agency itself calls the “voice of the CDC” ― has not provided accurate year-end numbers for hepatitis A, making the disease appear less widespread than it truly is.
A HuffPost analysis of CDC and California Department of Health data has found that from 2016 to 2017, hepatitis A cases shot up 48.7 percent nationwide ― an unprecedented spread of the sometimes deadly virus. That contrasts with what the CDC has reported in the MMWR: a mere 5.4 percent increase.
The CDC declined to publicly comment on the 48.7 percent figure.
But public health experts across the country point to a combination of forces that are driving the nationwide outbreak ― the vulnerable homeless population, whose numbers rose last year for the first time since 2010; rising illegal drug users, who often don’t seek or are unable to access medical care; and a lack of alternative sanitary services for those who don’t have housing.
“We’re continuing to have an affordable housing crunch, which means you have more homeless people. And oftentimes communities close the public bathrooms because of the opioid epidemic and people overdosing,” said Laura Hanen, interim executive director and chief of public affairs of the National Association of County and City Health Officials. “Some of that is likely contributing to what we’re seeing.”
What results are outbreaks like San Diego’s, which numbered over 580 cases from late 2016 through this March, including 20 deaths. Responding to the disaster has cost San Diego County’s health department more than $9.5 million. Michigan has seen its own outbreak spread across the state, culminating in 777 illnesses and 25 deaths since it began in a southeastern pocket of the state in August 2016. Louisville, Kentucky, which is the latest city to face an outbreak, has 128 sick and one dead since declaring that outbreak in November 2017, health officials told HuffPost.
“My guess is that we’re closer to the beginning than the end” of fighting the outbreak in Kentucky, said Dave Langdon, a public information officer for the Louisville Metro Department of Health and Wellness.