As hepatitis A outbreak wanes, county turns focus to the flu

A massive outreach to vaccinate people against hepatitis A helped to slow the spread of the virus.

Jan. 2, 2018 1:10 PM PT

County supervisors voted Tuesday to continue the hepatitis A emergency, though there were just six new cases added to the outbreak total in the last fortnight and the death total has held at 20 for more than two months.

But they were much more interested in what’s going on with the flu, which is nearing epidemic levels throughout the region.

Supervisor Ron Roberts and board chair Dianne Jacob both wondered if it was time for a similar public health emergency on influenza, given that the county’s most recent flu report, released on Dec. 26, documented 2,227 cases in a single week.

So far, the current flu season has produced a new-case rate five times higher than the prior three-year-average. The eleven deaths reported so far this year eclipse the four reported by the same week last year.

“This seems to be yesterday’s news,” Roberts said of hepatitis A, “and I’m wondering if maybe we should be thinking about what’s going on today?”

Roberts and Jacob said they have been alarmed to see how quickly the flu is spreading among their constituents, and seemed intent on making sure that the local public health push is as strong as possible.

“If we are not facing an emergency as a result of the flu epidemic, we may be soon,” Jacob said.

These statements come in the context of a hepatitis A outbreak in which the county has been criticized for not moving quickly enough to communicate the urgency of the emergency after a spike in cases was detected in March.

Officials did not declare a public health emergency until September. The outbreak went on to become the largest of its kind since the hepatitis A vaccine became available in the late 1990s.

Dr. Nick Yphantides, the county’s chief medical officer, noted that most flu years do have a few weeks where a large spike in case volume occurs. But those spikes usually arrive in January or February, not December.

“It’s still too early to tell if it’s going to be a flu season that outpaces other years, or if we are merely seeing a much earlier spike than we are accustomed to,” Yphantides said.

At this point, he added, declaring an emergency is not on the to-do list.

“We are not at the point, as of now, that we feel that there is any reason or practical justification for us to declare an emergency,” Yphantides said.

Still, the supervisors were especially keen on knowing what else could be done to help control the current spread of the flu among San Diego County residents.

“If we didn’t declare an emergency, I’d like to know what we can be doing, short of that, to see if we could reduce the number of people that are coming down with this,” Roberts said.

The supervisors will discuss the matter more fully at their next regular meeting on Tuesday, Jan. 9.

In the meantime, the health department is due to release its next weekly flu report on Wednesday, providing a snapshot look at activity throughout the region last week.

As for hepatitis A, the case total was increased to 577 Tuesday from a previous total of 571 reported on Dec. 19. County health officials have said they may lift the emergency declaration by the end of this month.

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