A Hepatitis A Crisis: Protecting our communities

About the Program

Category: Health (Best in Category)

Year: 2018

Large outbreaks of hepatitis A among persons experiencing homelessness or substance use disorder in various parts of California during 2017 prompted the Los Angeles County Department of Public Health to initiate a set of integrated strategies to prevent a similar outbreak within its jurisdiction. With nearly 58,000 homeless persons within its border, LA County perceived the threat to health as imminent and serious. Early efforts to quickly identify and respond to cases imported into the County were key in preventing a significant outbreak. Innovative strategies to manage cases and close contacts, identify and vaccinate thousands of at-risk persons, and improve environmental sanitation conditions at homeless encampments were effective at keeping the total number of cases to a minimum. Key efforts included adding clinicians to street outreach teams to offer vaccinations to individuals who are homeless and/or actively using illicit drugs, coordinating closely with agencies providing services/shelter to homeless and/or substance using individuals to ensure that both clients and staff were educated and vaccinated, educating and vaccinating first responders as well as staff and inmates at the jails, using multiple media platforms to inform the public and other key stakeholders about risk and key actions, and issuing guidelines to improve sanitation in the major encampments where homeless persons reside. Los Angeles County’s efforts resulted in only 17 homeless people contracting Hepatitis A over a 7-month period (in comparison to hundreds of cases in a nearby county) and can serve as model to other jurisdictions which may face a similar threat to the public’s health.