Los Angeles County, California, is grappling with a serious outbreak of hepatitis A, a viral illness known for its potential to cause severe liver damage and, in some cases, death. Health officials report a startling increase in cases, with the total for 2024 reaching 165—three times higher than the previous year and the highest count seen in a decade. Seven fatalities have been linked to the outbreak, which has persisted for over a year.
While hepatitis A infections have historically been concentrated among the homeless population due to limited access to sanitation facilities, this year’s trend shows a different demographic. Most of the recent cases have emerged among individuals who are neither homeless nor engaged in typical risk behaviors such as traveling to affected regions or using illicit drugs. “This disturbing rise in cases indicates a pressing need for immediate public health action,” said Dr. Muntu Davis, the county’s health officer, who is advocating for wider vaccination efforts.
In the first quarter of 2024 alone, health officials recorded 29 new hepatitis A cases, double the number from the same period in 2023. The virus spreads through ingestion of contaminated food and drink, and can also be transmitted through direct contact with infected individuals. Given the nature of the virus, experts believe the official numbers are likely an underrepresentation of its true prevalence, as many cases go undiagnosed.
Dr. Sharon Balter, leading the Division of Communicable Disease Control and Prevention, emphasized the need for healthcare providers to consider hepatitis A tests in patients presenting compatible symptoms, highlighting the outbreak’s potential scale. Reports from wastewater surveillance have shown fluctuating viral levels, further complicating the public health response. “Many individuals may not seek care while infected, underscoring the importance of these surveillance methods,” Balter noted.
Symptoms of hepatitis A can range from mild to severe—fever, fatigue, stomach pain, and jaundice are common indicators. While children often remain asymptomatic, adults typically display pronounced symptoms, and in some cases, the infection can lead to prolonged illness or liver failure. Dr. Prabhu Gounder, the county’s medical director for viral hepatitis, pointed out that the current outbreak strain suggests local transmission as opposed to cases imported from elsewhere.
Vaccination remains the most effective means of protection against hepatitis A, and the Centers for Disease Control and Prevention advocates for its administration in early childhood. Although vaccination was recommended for children starting in the mid-1990s, the absence of a requirement for older adults may have left a significant portion of the population unprotected. In light of the outbreak, public health officials are pushing for vaccinations among all county residents, particularly those who are homeless or use drugs.
The distribution of the hepatitis A vaccine has been extensive since the 1990s, and officials stress its safety and efficacy. People unsure of their vaccination status are encouraged to get the vaccine regardless, and good hygiene practices, like frequent handwashing, are being promoted to curb transmission.
With the ongoing rise in cases, experts are also expressing concern about potential budget cuts affecting public health funding. “Reduced federal funding could significantly hamper our efforts to track and respond to outbreaks, making it more challenging to protect the county’s health,” Balter warned.
As the situation develops, health officials stress the importance of early detection and preventive measures to contain the outbreak, emphasizing that community vigilance and a strong public health response are critical in navigating the complexities of this resurgence.