I recently noted that San Diego has officially declared a Hepatitis A emergency. Hepatitis A is an illness that is spread by contact with an infected person’s feces.

Since that initial report, a 16th person has succumbed to the disease and it has been revealed that the city had been warned repeatedly that a disease outbreak was likely to occur unless shortages in sanitation accommodations were addressed.

A San Diego Union-Tribune review of public records found that since 2000, four grand jury  reports emphasized the risks of human waste on city streets and a shortage of toilets available for use by the city’s growing homeless population.

One such report, filed in 2010, explicitly warned that an outbreak of illness caused by such unsanitary conditions “could result in liability to the city.”

Each of the reports called on the city to either add more all-hours, publicly available restrooms or bolster its street-cleaning regimen to ensure the public would not be exposed to human waste.

Health officials say such exposure helped fuel San Diego’s growing outbreak, which has left 16 people dead and more than 300 hospitalized.

The grand jury referenced above is a civil watchdog panel of 19 citizens, which investigates issues pertaining to local government and citizen complaints only.

Now, Los Angeles County public health authorities have officially declared an outbreak after nearly one dozen confirmed cases were recorded in the region.

Case numbers are still small in L.A. County, with only 10 people infected as part of the outbreak, said Dr. Barbara Ferrer, director of the L.A. County Department of Public Health. By comparison, almost 450 people have contracted the virus in San Diego.

Ferrer said the department is ramping up prevention efforts locally so more people don’t get sick. San Diego’s outbreak has already spread to Santa Cruz, where 69 people have been diagnosed.

…Ferrer said L.A. health workers will inspect homeless encampments in Los Angeles to improve sanitation, while spreading the word about improved hygiene. The city of Los Angeles is already cleaning the streets on skid row with bleach, a practice San Diego adopted earlier this month in an effort to reduce disease transmission.

Additionally, Santa Cruz has reported over 60 cases of the disease and public health agencies are struggling to deal with the transient nature of those being infected.

“The reason we’re particularly concerned (now) is because we have an outbreak in San Diego and we have an outbreak in Santa Cruz, and the contagion is in a population not easily contained,” said Dr. Sharon Balter, the chief of the department’s communicable disease control program.

The county typically sees about 40 to 60 cases of hepatitis A annually from the population at large, with a concentration often found among food-service workers. But those patients can be readily tracked and follow-up can be scheduled by phone or email, something that’s not possible when patients are living on the street.

Legal Insurrection readers may recall on our report about San Francisco’s “Poop Map”, an online reference people use to avoid human feces on the street. Not surprisingly, then, city officials are bracing for their own outbreak.

San Francisco, by comparison, has seen 13 confirmed cases so far this year, none of them fatal, according to health department spokesman Brent Andrew.

…Andrew said the city is working to increase the vaccination rates among adults and educate people about the need for hygiene.

“We’re doing quite a bit of outreach to the homeless population,” Andrew said, noting that this involved both homeless outreach workers and also healthcare workers encouraging people who come in for other matters to get vaccinated.

The city’s Public Works also has three crews dedicated to steam cleaning areas around homeless encampments and other locations that draw regular complaints about human waste.

It is often said that California is the Petri dish for failed progressive policies. It certainly appears that the analogy is apt.