Santa Cruz County health officials for more than two months have been waging an intensive battle against an outbreak of hepatitis A, a potentially deadly virus.
Since April 15, the county said it has confirmed 69 cases of hepatitis A. Usually it reports two to three cases per year countywide.
In the past week, the front lines of this public health campaign shifted to Boulder Creek, after the county learned that a delicatessen worker at the Redwood Keg Liquor & Deli contracted the illness.
The county acted quickly.
On Thursday, Sept. 7, the worker was ordered off the premises until at least this Wednesday. The deli counter was shut down for several hours on Sept. 7 as a county-supervised “bleaching” of all surfaces and equipment took place.
The county turned to social and broadcast media on Sept. 8, requesting that anyone “who consumed food prepared on-site at the Redwood Keg” between Aug. 15 and Sept. 7 get vaccinated for hepatitis A “as soon as possible.”
Special portable hand-washing stations were set up next to portable toilets at Junction Park in Boulder Creek, where one media report said as many as seven cases of hepatitis A had been identified by the county this summer.
The county set up a special two-hour free innoculation clinic in Boulder Creek on Tuesday, Sept. 12, for hepatitis A vaccinations.
“We are doing everything we can to get a handle on this, and hopefully we will,” Santa Cruz County Health Officer Dr. Arnold S. Leff said in a television interview. “We jumped on it right away and have been as aggressive as we can be in trying to curtail this outbreak.”
The county Health Services Agency said the investigation of the outbreak “is ongoing and challenging because of the long incubation period of the disease (15 to 50 days) and the difficulty experienced to contact many individuals sickened with the illness who are homeless and/or illicit drug users.”
Statistics released by Leff Wednesday showed that in Santa Cruz County, 73 percent of the cases were illicit drug users, and 77 percent of the victims were homeless. More than 85 percent of the cases were discovered in emergency room visits. Most cases have occurred in individuals with poor access to sanitary facilities
Nearly half of the reported cases in the county required hospitalization. There have been no fatalities.
“To date, no common source of food, beverage, or other cause has been identified; as a result, the source of the outbreak remains undetermined,” the county reported.
The Redwood Keg was the first food establishment closed even temporarily by the county in response to a reported hepatitis infection.
Hepatitis A is an inflammation of the liver and is usually transmitted through the fecal-oral route, including person-to-person contact, touching contaminated surfaces or consuming contaminated food or water. For more information, please visit https://www.cdc.gov/hepatitis/hav.
Symptoms of hepatitis A include jaundice (yellowing of the skin and eyes), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, and light-colored stools. Symptoms usually appear over a number of days and last less than two months. However, some people can be ill for as long as six months. Hepatitis A can sometimes cause liver failure and even death.
Leff is giving additional direction to the community, including:
Direction to business owners on maintaining healthy environments, focusing on proper cleaning procedures for cleaning public restrooms and proper food handling techniques. These include:
Cleaning and disinfecting bathrooms using chlorine bleach, including multiple times per day in heavily trafficked areas.
Properly cleaning hard surfaces, including food prep areas.
Assuring that employees thoroughly wash hands with soap and water for at least 20 seconds, rinsing with clean water and properly drying hands and arms.
The use and proper disposal of latex gloves while cleaning.
Additional information is available at www.healthservicesagency.org/hepa
