Aug. 29 (UPI) -- At least 14 people have died of hepatitis A in San Diego this year in an outbreak that has greatly impacted the city's homeless community, according to county officials.
In a report by the San Diego Health & Human Services Agency, officials said the majority of people who have contracted hepatitis A are "homeless and/or illicit drug users."
"The outbreak is being spread person-to-person and through contact with a fecally contaminated environment," the report said. "No common sources of food, beverage or drugs have been identified that have contributed to this outbreak, though investigation is ongoing."
Since November 2016, the agency has documented 352 cases of hepatitis A resulting in 14 deaths and 264 hospitalizations. Between 2012 and 2016, the county averaged only 28 acute hepatitis A cases throughout the entirety of each year.
In just the past week, San Diego County has confirmed 19 new cases and 32 new hospitalizations, reported the San Diego Tribune. Those numbers are greater than every single-state hepatitis outbreak documented by the U.S. Centers for Disease Control and Prevention's foodborne illness-tracking database since 1998.
An increasing number of homeless people living and eating in unsanitary conditions could be the cause for the outbreak in San Diego, according to Dr. Rohit Loomba, director of hepatology at the University of California at San Diego.
"My gut feeling is it was a common source where somebody might have given food to a group of homeless individuals," Loomba told The Guardian.
Loombba explained that once the disease got into the population, it could have spread through personal contact.
"They don't have a clean water supply to wash their hands, and once they have hepatitis A, then they become a source for another person," he said.
Hepatitis A is a liver infection caused by the Hepatitis A virus (HAV) and is highly contagious, according to the San Diego HHSA. An infection can cause liver disease that lasts several weeks or months. It can also cause death. It spreads through touching objects or eating food handled by somebody with hepatitis A, as well as through sexual contact.
In an effort to prevent more infections, San Diego County has taken measures to make hand-washing more available to homeless people. But some complain that this should have been done when county officials were first aware of an outbreak months ago.
"I'm no expert on proper responses to public health crises or viral outbreaks, but what I do see a pattern of is a lack of urgency when it involves homeless people, and this really seems to be no different," said homeless advocate Michael McConnell. "How hard is it to make sure there's additional hand-washing stations?"