Author Topic: california Hep A outbreak  (Read 3537 times)

Offline mountainmoma

  • Survival Demonstrator
  • *******
  • Posts: 4419
  • Karma: 199
  • suburban homesteader
california Hep A outbreak
« on: September 27, 2017, 06:16:41 PM »
Dont know if it goes here, or news. I put it here, thinking people could discuss ways to guard against catching it, or treating it, etc... in possible future emergency scenarios where sanitation is reduced.

https://www.news-medical.net/news/20170926/California-scrambles-to-contain-e28098unprecedentede28099-hepatitis-A-outbreaks.aspx

I believe there is alot left out of this, as alot of drug users are not homeless and do work, albeit often at lower paid or part time work due to their "issues" . Not to mention people, again not homeless or drug users, who hook up sexually with someone carrying the illness, paid sex, or just meet them at a party or beach or bar....

For example, in Santa Cruz county, a deli is identified as a location of concern. Must be an employee there was diagnosed, as any customers there between certain dates are being recommended to get the vaccine, and the first day of free vaccines for this customer population overwhelmed the first offering and a second day/time for the free vaccines is schedualed (or has happend, I foget which date was on the notice).

Now, seems to me that if an employee followed rules, it shouldnt be much of an issue, if they wash their own hands thouroughly and wear plastic gloves each time contacting the food ? But, sandwich makers do not wear masks, so I guess breathing on the food could transport droplets, and of course, many employees do not take cleanliness as seriously as they should. Yes, out of towners passing thru could easily have been exposed there, or just about anywhere, given the filth at the beaches and parks. Or, the employee may just handle money, and maybe the rest of us eat something without washing our hands.

found a link to local news on it, http://www.santacruzsentinel.com/article/NE/20170912/NEWS/170919872   cases associated with a deli, laudromat, county jail, etc....
« Last Edit: September 27, 2017, 06:45:52 PM by mountainmoma »

Offline RitaRose1945

  • Survival Veteran
  • ********
  • Posts: 5526
  • Karma: 403
  • Asking the uncomfortable questions since 1964
Re: california Hep A outbreak
« Reply #1 on: September 27, 2017, 07:45:58 PM »
You can vaccinate against it, but since so many people are anti-vaxx now, a lot of diseases that were on their way out have made a resurgence.  It's very common to get it from workers handling food with contaminated hands.

From the CDC:

Hepatitis A is usually spread when the Hepatitis A virus is taken in by mouth from contact with objects, food, or drinks contaminated by the feces (or stool) of an infected person. A person can get Hepatitis A through:Person to person contactwhen an infected person does not wash his or her hands properly after going to the bathroom and touches other objects or food
  • when a parent or caregiver does not properly wash his or her hands after changing diapers or cleaning up the stool of an infected person
  • when someone has sex or sexual contact with an infected person. (not limited to anal-oral contact)
  • Contaminated food or water
  • Hepatitis A can be spread by eating or drinking food or water contaminated with the virus. (This can include frozen or undercooked food.) This is more likely to occur in countries where Hepatitis A is common and in areas where there are poor sanitary conditions or poor personal hygiene. The food and drinks most likely to be contaminated are fruits, vegetables, shellfish, ice, and water. In the United States, chlorination of water kills Hepatitis A virus that enters the water supply.


Offline mountainmoma

  • Survival Demonstrator
  • *******
  • Posts: 4419
  • Karma: 199
  • suburban homesteader
Re: california Hep A outbreak
« Reply #2 on: September 27, 2017, 08:31:05 PM »
Hep A is considered a third world problem and not an issue here in the US, which is why this is news. We were thought to have basically erradicated it here, you just never hear of outbreaks like this, until this one. We are not a country were it is recommended to vaccinate against this, unless you are part of a vulnerable population, work with a vulnerable population or are less able to fight it off. It is a nasty illness, not usually life threatening at all, but people with other health issues, like the addicts, it is harder to fight it off.

Here is the WHO recommends
Quote
Recommended for: Hepatitis A vaccination should be considered for individuals aged ≥1 year who are travelling to countries or areas with moderate to high risk of infection. Those at high risk of acquiring severe disease, such as immunosuppressed patients and patients with chronic liver disease, should be strongly encouraged to be vaccinated regardless of where they travel.


And, the USA is not a country with moderate to high risk of infection

so, this has nothing to do with anti-vaxxers !!!

http://www.who.int/ith/vaccines/hepatitisA/en/

What is interesting is to remind us all about being more vigilant, take better precautions, for this one, or others that could arise.

If you look at the public health issues brought by people defacating in the streets and lawns at parks, etc... -- this is the issue !

Missplaced compassion has been allowing people to sleep on sidewalks, spit and defecate on sidewalks, even when toileets are provided, I have seen it. Doesnt matter if a toilet is 20feet away ! Allowing people to do this on crowded, public areas is a disaster waitng to happen, and hep A is not the nastiest of the posibiliteis at all.

here is the WHO information regarding Hep A and the USA, http://www.who.int/csr/don/07-june-2017-hepatitis-a/en/   

Quote
Between June 2016 and mid-May 2017, an unusual increase in cases of hepatitis A affecting mainly men who have sex with men (MSM) has been reported by low endemicity countries in the European Region, and in the Americas (Chile and the United States of America).
.....
n low endemicity settings, WHO recommends hepatitis A vaccination for high-risk groups, such as travellers to endemic areas, MSM, people who inject drugs, and chronic liver disease patients.* For MSM the main risk factor is related to sexual transmission, particularly oral-anal sexual contact. Most of the affected countries have routinely recommended hepatitis A vaccine for MSM.

This event is of particular concern from a public health perspective because of the current limited availability of hepatitis A vaccine worldwide. In addition, several national and international lesbian, gay, bisexual, and transgender (LGBT) pride festivals will take place between June and September 2017, including the World Pride Festival in Madrid, Spain between 23 June and 2 July 2017.
« Last Edit: September 27, 2017, 08:50:22 PM by mountainmoma »

Offline RitaRose1945

  • Survival Veteran
  • ********
  • Posts: 5526
  • Karma: 403
  • Asking the uncomfortable questions since 1964
Re: california Hep A outbreak
« Reply #3 on: September 27, 2017, 09:13:17 PM »
Where I work, pretty much everyone does because we work around patients, including those who are higher than average risk.  We don't want to get it, then spread it to others who can't fight it off as easily.

I'm not trying to turn this into a pro/anti vaccine issue.  Unless you don't ever eat out or have sex, the vaccine might be a helpful preventative for someone.  Or not.  Everyone chooses their own comfort level when it comes to risk.

Either way, the issue is not that an individual might not be high risk, it's that they can't control the risk level of those with whom they come in contact, even casually, that might pass it on through something as innocuous as a fork or a slice of cheese.

Offline Ms. Albatross

  • Dedicated Contributor
  • ******
  • Posts: 1746
  • Karma: 138
Hepatitis A outbreak
« Reply #4 on: October 16, 2017, 02:24:12 PM »
16 people have died and 490 people have contracted Hep A in San Diego County.  Governor Brown has declared a state of emergency.  Most of the outbreak has occurred among the homeless population.   http://www.latimes.com/local/california/la-me-ln-hepatitis-california-20171013-story.html?scrlybrkr=fd2e9b28

My developmentally disabled son rides public transportation so he is around homeless people.  My husband decided to that he should get the Hep A vaccine.  I'm debating whether or not to get it.  My husband thinks I should because I work in a low-income neighborhood and I frequent public libraries (which the homeless frequent).

Any thoughts?  I'm not an anti-vaxer but I do think we way over-vaccinate.  Would you get the vaccination if you were in my shoes?

Offline redrider

  • Prepper
  • **
  • Posts: 86
  • Karma: 9
  • Purveyor of Post Drills
Re: Hepatitis A outbreak
« Reply #5 on: October 16, 2017, 02:27:59 PM »
Heck yeah!

I assume you like your liver? Feel like it's a necessary part of your life?

I would RUN to get a vaccine if I were you.

But in the end, it's just my two cents...

rr


Offline chad

  • Dedicated Contributor
  • ******
  • Posts: 1191
  • Karma: 43
Re: Hepatitis A outbreak
« Reply #6 on: October 16, 2017, 02:45:06 PM »
What's the vector Victor...I just had to say it ::)

Seriously, how easily is it transmitted?

Offline FreeLancer

  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 6083
  • Karma: 771
Re: Hepatitis A outbreak
« Reply #7 on: October 16, 2017, 02:48:02 PM »
Get it.

Offline Ms. Albatross

  • Dedicated Contributor
  • ******
  • Posts: 1746
  • Karma: 138
Re: Hepatitis A outbreak
« Reply #8 on: October 16, 2017, 02:56:07 PM »

Seriously, how easily is it transmitted?

My understanding is that it is transmitted via fecal matter.  The homeless don't have access to, or don't use, hand washing facilities.  We have a huge homeless population here.
« Last Edit: October 16, 2017, 03:02:20 PM by Ms. Albatross »

Offline chad

  • Dedicated Contributor
  • ******
  • Posts: 1191
  • Karma: 43
Re: Hepatitis A outbreak
« Reply #9 on: October 16, 2017, 03:06:42 PM »
My understanding is that it is transmitted via fecal matter.  The homeless don't have access to, or don't use, hand washing facilities.  We have a huge homeless population here.

I'd seriously think about it. I wonder what the side effects of the vaccine are if any.

Offline David in MN

  • Survival Demonstrator
  • *******
  • Posts: 2113
  • Karma: 162
Re: Hepatitis A outbreak
« Reply #10 on: October 16, 2017, 03:40:52 PM »
Even if you question the safety of the vaccine schedule (and I do) getting one specific vaccine for a local problem is far off from the schedule given to kids under 2. Even if vaccines cause autism (I doubt this) you're past the risk point.

I'd do it. You're mitigating an appreciable risk with a very low risk procedure.

FWIW I actually have been more active keeping up my vaccines. We have outbreak problems in the Somali community and I have some exposure through friends. I do think the schedule for kids is a little aggressive and I don't like the methodology of the data (comparing to previous schedule rather than a true control) but most of my beef comes from my data analysis background. There's no hard evidence, just poor science. Adult vaccines carry almost no risk.

I do avoid the flu vaccine. It's not mathematically effective based on my number crunching. My wife gets it and I don't try to stop her. Not being effective doesn't prove that it is harmful. One could argue it's valid if only as a placebo.

I'm sure I pissed off both sides.

Offline mountainmoma

  • Survival Demonstrator
  • *******
  • Posts: 4419
  • Karma: 199
  • suburban homesteader
Re: Hepatitis A outbreak
« Reply #11 on: October 16, 2017, 04:03:56 PM »
Hep A is not serious for most of us who do not have compromised immune systems. The homeless are not the only carriers, the other significant population getting it are MSM, what World Health Organizations acronym for male-to-male sex, WHO has cited an outbreak in certain countries due to this population since April, USA is one of those countries. Homeless, addicts, etc... have more trouble fighting it off and more serious health complications, esp if they already have Hep B or C, many other mild cases in general population are likely not even seeing a doctor.

I agree that adverse vaccine reaction for an adult are not as serious as for a child, esp for this vaccine. So then you weigh the pros and cons, how is your immune system, how much contact with at risk populations. Personally, and I am considered an anti-vaxer on this forum as most do not acknowledge the various risk factors, esp. for children and force being used to compel getting them, etc..., anyways, personally I would recommend to your son to get this vaccine given the issues in your area and his disabilities. I do not see a low income area as a riskier population. Depends how diligent you are about the library, just do not even think about going into the library bathroom, wash hands with sanitizer before driving and when get home. Hep A is not Hep B or C, it is much milder. I must say my youngest got it last month, she did not react to that one, she did react to either the diptheria or MMR ( got those earlier in summer at the same time) she was pretty miserable for those. SHe decided to get Hep A as she intended to eat street food while traveling in southern asia, and was getting back a few days before moving to university, so did not want to potentially be sick. If she had travelled earlier in the summer, she may have elected to skip it. For you, it is not so clear as for your son, not many risks for you to get it or to have adverse reaction, so either way you feel less stressed.

Offline Cedar

  • ...just aDD water...
  • TSP Supreme Galactic Ant
  • ************
  • Posts: 28429
  • Karma: 1396
  • Dont wait for the storm to pass, dance in the rain
Re: Hepatitis A outbreak
« Reply #12 on: October 16, 2017, 10:40:59 PM »
If you are high risk, I'd get it. The low risk of getting problems from the vaccine seem much smaller than your exposure to Hep A

Cedar

Offline mountainmoma

  • Survival Demonstrator
  • *******
  • Posts: 4419
  • Karma: 199
  • suburban homesteader
Re: Hepatitis A outbreak
« Reply #13 on: October 17, 2017, 12:18:47 AM »
Already thread on this here, http://thesurvivalpodcast.com/forum/index.php?topic=61299.msg729071#msg729071

likely these two threads should be merged

Offline FreeLancer

  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 6083
  • Karma: 771
Re: Hepatitis A outbreak
« Reply #14 on: October 17, 2017, 12:35:34 AM »

Offline surfivor

  • Survival Veteran
  • ********
  • Posts: 7064
  • Karma: 104
Re: california Hep A outbreak
« Reply #15 on: October 17, 2017, 09:40:44 AM »
 I would try to find out more about it but I have heard little or nothing about hep A and would not become panicked.

 The current outbreak has reportedly killed 17 people and effected others. I don't trust health officials to report things accurately anyway. There's probably a very good chance that since CA is pushing mandatory vaccines they need to come up with or focus on some outbreaks to scare the population

 Previously the worst outbreak killed 4 people and was caused by food contamination

https://en.wikipedia.org/wiki/2003_United_States_hepatitis_A_outbreak

The 2003 United States hepatitis A outbreak was the most widespread hepatitis A outbreak in the United States. It afflicted at least 640 people, killing 4, in north-eastern Ohio and south-western Pennsylvania in late 2003. The outbreak was blamed on tainted green onions at a Chi-Chi's restaurant in Monaca, Pennsylvania.

Offline Smurf Hunter

  • Survival Veteran
  • ********
  • Posts: 7172
  • Karma: 334
Re: Hepatitis A outbreak
« Reply #16 on: October 17, 2017, 10:57:40 AM »
Even if you question the safety of the vaccine schedule (and I do) getting one specific vaccine for a local problem is far off from the schedule given to kids under 2. Even if vaccines cause autism (I doubt this) you're past the risk point.

I'd do it. You're mitigating an appreciable risk with a very low risk procedure.

FWIW I actually have been more active keeping up my vaccines. We have outbreak problems in the Somali community and I have some exposure through friends. I do think the schedule for kids is a little aggressive and I don't like the methodology of the data (comparing to previous schedule rather than a true control) but most of my beef comes from my data analysis background. There's no hard evidence, just poor science. Adult vaccines carry almost no risk.

I do avoid the flu vaccine. It's not mathematically effective based on my number crunching. My wife gets it and I don't try to stop her. Not being effective doesn't prove that it is harmful. One could argue it's valid if only as a placebo.

I'm sure I pissed off both sides.

I have two close friends with autistic children.  Both firmly stated they'd rather their child live with autism than die or be crippled by polio.

Also, on a personal note as my son has a severely compromised immune system, he has had nearly every vaccine available in the last 18 months.  He's 13 now.
This has really changed my perspective.  Not that I'm pro or anti, but rather "how nice you have the luxury of a debate".


Offline LvsChant

  • Resident Master Mudder
  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 7257
  • Karma: 603
Re: california Hep A outbreak
« Reply #17 on: October 17, 2017, 11:43:52 AM »
When my boys were babies, we were informed by our pediatrician that NM was a high-risk state for Hep A. So... we got the boys vaccinated on the schedule recommended. Didn't really consider it for myself, but perhaps I should.

We did get our oldest son vaccinated for Hep C before going off to college also. We never had any problems or side effects for our boys beyond the normal soreness and feel it is a wonderful thing to be able to prevent these illnesses. For example... when is the last time you heard of anyone you knew dying from tetanus? We are indeed very spoiled to get to make those choices now.

And... for the anti-vaccine folks, you are being protected to some degree by the rest of us who do vaccinate... so please no criticism of those of us who do vaccinate our children :) (And I won't criticize you for choosing otherwise for whatever reason).

Offline mountainmoma

  • Survival Demonstrator
  • *******
  • Posts: 4419
  • Karma: 199
  • suburban homesteader
Re: california Hep A outbreak
« Reply #18 on: October 20, 2017, 01:08:33 AM »
And, back to Hep A.

And how to make it worse. Santa Cruz, one of the 3 areas having an epidemic of it has just had its new chief of police say that he is going to stop enforcing the camping ban. First anecdotal impressions are that more people are now camping in the large public park and sidewalks by Costco -- He did convince the campers by the post office to move on, large rats were observed coming out of sleeping areas there. Maybe we will have the plague next.

Unsanitary conditions lead to public health problems and disease. Bringing unsanitary conditions into what should be clean areas, like playgrounds at the park, the library, the post office steps, public sidewalks in crowded shopping areas leads to diseases spreading, all kinds of them. It seems imperitive to public health to enforce no public spitting, no public shooting up and defecation. We are allowing people who dont give a damn to act in ways in public areas that are obvious public health issues. When did our priorities get so messed up ? Hep A is mild compared to what we will be in for if we do not prioritize basic sanitation issues. We have also basically decriminalized purposly infecting in California, for example, it is no longer a felony to have sex with someone without telling them you have HIV. Misdemeaners no longer have any deterrent effect here as they are not punished, so if you have HIV or herpes or hepatitis A, B or C, no big deal, we wouldnt want you to feel bad or not get laid, so dont tell them....   We have more Tb too. We need to prioritize basic public health practices of not spreading this stuff around, these germs.

Offline mountainmoma

  • Survival Demonstrator
  • *******
  • Posts: 4419
  • Karma: 199
  • suburban homesteader
Re: california Hep A outbreak
« Reply #19 on: October 20, 2017, 12:21:54 PM »
And, back to Hep A.

And how to make it worse. Santa Cruz, one of the 3 areas having an epidemic of it has just had its new chief of police say that he is going to stop enforcing the camping ban. First anecdotal impressions are that more people are now camping in the large public park and sidewalks by Costco -- He did convince the campers by the post office to move on, large rats were observed coming out of sleeping areas there. Maybe we will have the plague next.

Unsanitary conditions lead to public health problems and disease. Bringing unsanitary conditions into what should be clean areas, like playgrounds at the park, the library, the post office steps, public sidewalks in crowded shopping areas leads to diseases spreading, all kinds of them. It seems imperitive to public health to enforce no public spitting, no public shooting up and defecation. We are allowing people who dont give a damn to act in ways in public areas that are obvious public health issues. When did our priorities get so messed up ? Hep A is mild compared to what we will be in for if we do not prioritize basic sanitation issues. We have also basically decriminalized purposly infecting in California, for example, it is no longer a felony to have sex with someone without telling them you have HIV. Misdemeaners no longer have any deterrent effect here as they are not punished, so if you have HIV or herpes or hepatitis A, B or C, no big deal, we wouldnt want you to feel bad or not get laid, so dont tell them....   We have more Tb too. We need to prioritize basic public health practices of not spreading this stuff around, these germs.

I have heard that San Diego is taking action on people sleeping on public sidewalks, due to this health emergency. Maybe Ms. Albatros can update afterimplementation with a local veiwpoint

Offline Ms. Albatross

  • Dedicated Contributor
  • ******
  • Posts: 1746
  • Karma: 138
Re: california Hep A outbreak
« Reply #20 on: October 20, 2017, 02:16:06 PM »
I have heard that San Diego is taking action on people sleeping on public sidewalks, due to this health emergency. Maybe Ms. Albatros can update afterimplementation with a local veiwpoint

I was going to get the vaccination this weekend but almost everyone is out and they only want to vaccinate high risk individuals.

Quote
While declining to say exactly how many doses the county has on hand, Wooten [Dr. Wilma Wooten, San Diego County's public health officer] said she believes that there is enough supply to keep giving shots to those who are at highest risk of infection, including homeless residents, drug users, those with existing liver disease, gay men and those with compromised immune systems.

Anyone outside specified at-risk groups, she added, are now being actively advised to wait due to the constraints on vaccine supply mentioned last week by the state.

"We are asking health providers to not vaccinate those individuals right now that might want to be immune to wait until the beginning of the year when more vaccine is available," Wooten said.

Another quote from the article.  It's hard for me to believe they don't have a better estimate of how many homeless people there are. 
Quote
She did say that there are estimated to be about 125,000 intravenous drug and methamphetamine users who are at risk along with somewhere between 9,000 and 25,000 people who are either homeless or who have insecure living conditions.

In response to the outbreak, there are attempts to get some off the downtown streets.  A "campground" on city owned land has been set up and it seems to be targeted for homeless women. 
Quote
Dozens of women, ranging from mothers with young children to seniors with walkers, arrived at the city’s first sanctioned homeless camp Monday with a mixture of trepidation, anxiety and hope.  [It] is expected to hold about 200 people. Monday was move-in day for about 65, including some of the most vulnerable on the street.

As the first wave arrived, the condition of some woman who might have been on the streets the night before was alarming. Many appeared to be at least in their 60s. One was severely hunched over and used a walker, one woman had a pronounced limp and a third had braces on both wrists.

A later wave of women were younger and healthier, but likely had other issues. Most of the arrivals Monday were picked up from Rachel’s Women’s Center, a drop-in facility that provides services for women who are homeless, have physical disabilities, are mentally or emotionally disturbed or in recovery.

I saw a news report two days ago about a Jewish community center that allows car camping.  They are strictly regulating who is allowed to stay and they have to sign behavior contracts.  The family they interviewed were very articulate and they were white and looked like educated middle class.

I was in downtown San Diego (to go to the main branch of the public library - which is ground-zero for the homeless population downtown) earlier this week and I saw usual numbers of homeless people.  I saw hand washing stations.  I've heard they are continuously washing down and bleaching sidewalk areas where the homeless congregate.


Offline mountainmoma

  • Survival Demonstrator
  • *******
  • Posts: 4419
  • Karma: 199
  • suburban homesteader
Re: california Hep A outbreak
« Reply #21 on: October 20, 2017, 06:59:42 PM »
DO you have a link to that article ?