As of 14 Aug 2017, 333 confirmed or probable Hepatitis A virus (HAV) cases have been reported in an ongoing outbreak in San Diego County. Seventy percent of the cases have been hospitalized, and 3 percent of patients have died. The cases range in age from 19 to 87 years, 68% are male. Approximately, 39% of the HAV cases are homeless and reported injection or non-injection illicit drug use. Of the cases with released test results, 22 % have chronic hepatitis C infection, and 6 % have chronic hepatitis B infection.
Person-to-person transmission through the fecal-oral route is the primary means of HAV transmission in the USA. Most infections result from close personal contact with an infected household member or sexual partner, or their fecal-contaminated environment. Hands may play a significant role in the direct and indirect spread of HAV. Common source outbreaks and sporadic cases can also occur from exposure to fecal-contaminated food or water. Fecal Coliform testing, using a swab or wipe is one of the easiest and fastest ways to detect fecal contamination on surfaces. Although a positive coliform test does not detect HAV, it does provide the evidence of the potential for HAV contamination, because the virus is present in the feces of infected individuals. Locations with with positive coliforms must be thoroughly disinfected. Follow up testing is recommended after disinfection to ensure contamination has been mitigated. Typical fecal coliform tests time for results is 48 hours.