Lessons From San Diego's Hepatitis A Outbreak

Lisa Halverstadt provides in-depth, behind-the-scenes reporting on a massive public health scare that finally came to national attention this month in San Diego, after hundreds were infected with Hepatitis A. (Hepatitis A is a viral liver disease transmitted through ingestion of contaminated food and water or through direct contact with an infectious person, according to the World Health Organization's definition.)

Halverstadt reports on the disparate experience on the citizens who contracted Hepatitis A, while officials from the city and the country of San Diego delayed in a response. An initial email alert about a growing number of Hep A cases, sent in March, didn’t draw much attention, according to Halverstadt. That initial alert reported 19 cases, but by mid-April that number had climbed to 42, and two had died. "By early May, the situation worsened. Three patients were dead, and there were 80 documented cases," adds Halverstadt. By June that number reached 160 cases, with the death toll rising to four.

Halverstadt tracks the response of city and county officials alongside the growing number of documented cases. Of concern to planners and anyone interested in the relationship between public health and the built environment were the city's lack of sanitation stations, and its inability to roll out more facilities. "On July 13, two hand-washing stations went up outside a quiet county health complex in Midway, miles from downtown streets considered ground zero of the outbreak," according to Halverstadt. "County health officials said they believed poor hygiene fueled the spread of the virus, yet efforts to deploy more hand-washing stations stalled for weeks." Another story by James deHaven reports that San Diego officials were repeatedly warned about a lack of public bathrooms in the city's downtown. Paul Sisson reports that commuters are now afraid to take public transit.

In September, the story of San Diego's Hepatitis A outbreak went national, punctuated by the story of the city bleaching its streets in response to the spread of the virus, and the Los Angeles Times began to wonder if the outbreak could be coming to the larger city to the north, with its massive homeless population and similar lack of sanitation resources.