California’s Hepatitis A Outbreak: What You Should Know

Our state is experiencing an unprecedented outbreak of the hepatitis A virus. Since its initial detection in early March, 19 Californians have lost their lives to the virus. San Diego County public health officials have confirmed hundreds of hepatitis A cases and the outbreak has spread to other counties, including Los Angeles and Santa Cruz. Other counties may soon be affected.

In an effort to control the outbreak, Gov. Jerry Brown declared a state of emergency to increase the supply of hepatitis A vaccines in California. Assembly offices in affected districts are committed to providing the latest updates and resources on California’s Hepatitis A outbreak.

Here’s information you need to know right now:

What is Hepatitis A?
Hepatitis A virus is highly contagious and infects the liver. It can cause liver disease, lasting a few weeks to a serious illness lasting months. In some cases, people can die.

How is it spread? (How did California’s current outbreak happen?)
The virus is primarily spread in the United States by ingesting food or water contaminated by feces of an infected person. California’s outbreak is being spread person-to-person and through contact with fecally contaminated environments. The majority of people who have contracted hepatitis A during this outbreak have been homeless and/or illicit drug users.
The hepatitis A strain in this outbreak is not considered a more contagious strain, according to the California Department of Public Health. The affected population likely has more underlying conditions causing chronic liver disease, which can result in more severe disease when hepatitis A infection occurs.

What are the symptoms of hepatitis A?
According to the Center for Disease Control and Prevention (CDCP), symptoms usually occur quickly and can include the following: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and yellowing of the whites of the eyes/skin (known as jaundice).

What is being done to control the outbreak?
If a hepatitis A case is reported, local health departments will provide all contacts the infected person might have had during their infectious period with postexposure prophylaxis (PEP), a hepatitis A vaccine. Handwashing stations and toilets are two additional prevention control measure being used to help reduce the risk of transmission. Waterless hand sanitizers are also not effective.

Who should get the hepatitis A vaccination?
Hepatitis A vaccination has been recommended for all children in California since 1999, therefore, most adults in California have not been routinely vaccinated against hepatitis A. The CDCP routinely recommends vaccinations for:


  • People with clotting factor disorders.
  • People who conduct laboratory research with the virus.
  • Travelers to countries where hepatitis A is common.
  • People in close personal contact with adopted children from countries where hepatitis A is common.

Public Health Offices strongly recommend the following groups be vaccinated:

  • People who are homeless.
  • Users of illegal drugs.
  • Men who have sex with men.
  • People with chronic liver disease, such as cirrhosis, hepatitis B, or hepatitis C. They may not be at increased risk of getting hepatitis A but are at increased risk of poor outcomes if infected.
  • People who work with, provide services to, or clean up after the homeless and/or illegal drug users
  • Food handlers who have adult clients. Food handlers are not at increased risk, but if infected can impact large number of people. Children get routine vaccinations for hepatitis A, so vaccination is not recommended for food handlers in schools unless they are in an at-risk group.
  • Anyone who is concerned about hepatitis A virus exposure and wants to be immune. During the present outbreak, hepatitis A vaccine is not being recommended for general public.