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DPH says San Francisco has no hepatitis A outbreak but urges vaccination and sanitation measures
Summary
DPH officials briefed the commission on hepatitis A risk after large outbreaks elsewhere, saying San Francisco is not experiencing an outbreak but is ramping vaccinations (shelters, street medicine, clinics, jail) and monitoring sanitation and public‑toilet availability.
Department of Public Health communicable-disease staff told commissioners that San Francisco is not currently experiencing a hepatitis A outbreak but remains at risk given recent large outbreaks in other California counties.
"We have no outbreak in San Francisco at this time, but we believe that we could be at risk for an outbreak," Dr. Cora Hoover, communicable disease controller, said as she outlined the department's response. She and Dr. Thomas Aragon explained that recent outbreaks have disproportionately affected people experiencing homelessness and people who use drugs.
Hoover described the city's prevention focus: expanding vaccination in targeted venues including Tom Waddell clinics, street medicine teams, shelters and the county jail, and reinforcing routine immunizations in primary care. She noted that the California Department of Public Health in July recommended adding homelessness as an indication for hepatitis A immunization.
Commissioners asked about transmission and non‑vaccine interventions. Hoover explained hepatitis A is enteric and spreads via close personal contact; she noted that tracing and offering post‑exposure prophylaxis to close contacts is a key case‑investigation tool. Commissioners raised sanitation measures; Hoover observed that San Diego has recently implemented expanded public‑toilet access and that sanitation measures are a longstanding prevention tool. Director Garcia said DPH has been coordinating with NAV, shelter health and DPW and will consider calling an emergency response if unlinked local cases appear.
The department said it is monitoring neighboring counties' outbreaks, maintaining high vaccination coverage among identified homeless populations and preparing to escalate resources — including additional sanitation and public‑toilet deployment — if cases are detected locally.
