We have been following the outbreak of Hepatitis A as it has spread among the homeless and drug-users of California, into Utah, Michigan and Colorado.

Public health officials are now reporting a significant uptick of cases of the disease in Kentucky. Genetic tests indicate the strain of the virus, which is transmitted via fecal matter and cause life-threatening effects on the liver, is the same strain as the one from Southern California.

Kentucky has become the fifth state to declare an outbreak of hepatitis A, reporting the 31 cases so far this represent a 55 percent increase over the annual averages for the past 10 years.

….In Kentucky, 31 cases of acute hepatitis A, defined partially by the rapid onset of symptoms, had been confirmed as of Tuesday. Of those, 19 are in Jefferson County, which includes Louisville, KY, making it the most populated and most urban county in the state. The state usually records an average of 20 cases annually, according to a health alert from the Kentucky Department of Public Health.

“… laboratory specimens from recently diagnosed cases have been sent for specialized genetic testing of the hepatitis A virus at the Centers of Disease Control and Prevention in Atlanta,” according to the Kentucky alert.

“Thus far test results match the genotype associated with an acute Hepatitis A outbreaks in California.”

Back in California, officials are still struggling to contain the spread. Legal Insurrection readers may recall the heady days of health like when San Francisco was promoting its open-air urinals.

Now California activists are clamoring for more public toilets.

Reports compiled by volunteer organizations have faulted city officials for not providing enough accessible toilets as the homeless population sharply increased by 23 percent this year.

In a prescient warning, a June 2017 report by a collection of nonprofits called the LA Central Providers Collaborative sounded the alarm about crowding and living conditions on Skid Row, citing the city’s own predictions about the increased risk for hepatitis A and other diseases.

“One would think that Los Angeles, one of the greatest cities in the world, would exceed these minimal standards. However, this Audit finds that in Skid Row, Los Angeles fails to meet even the standards for a refugee camp,” the report said. “During overnight hours, there are only nine public toilets available for 1,777 unsheltered homeless people on Skid Row, and these toilets are largely inaccessible.”

The report noted that United Nations’ refugee camp standards are one toilet for every 20 people.

I will simply point out that the $1.3 billion paid by Los Angeles over the past 2 years for illegal immigrant welfare could have purchased quite a few port-a-potties.

Furthermore, California politicos may want to rethink the plastic bag ban. The uptick in the disease seems to correspond with the sudden lack of free and easy human waste disposal options for the homeless.

It is said that as California goes, so goes the country. The spread of hepatitis A seems to prove that the Golden State is the national trendsetter for infectious diseases.

Officials in the remaining 45 states that have sizeable homeless communities and areas in which illegal drug use is prevalent would be wise to start making appropriate infection control plans.