Hepatitis A Outbreak Hits Los Angeles County

LOS ANGELES, CA — Los Angeles County is in the midst of a community-wide hepatitis A outbreak, county health officials declared Monday.

Health officials are seeing a steady rise in cases, and wastewater is confirming the spread of the virus, according to the Los Angeles County Department of Public Health. Residents can reduce their overall risk of infection and reduce the spread of the virus by getting vaccinated.

"The ongoing increase in hepatitis A cases signals that quick action is needed to protect public health," Los Angeles County Health Officer Muntu Davis said in a statement. "Getting vaccinated is simple, and it's one of the most important things you can do for your own health and the health of our entire community. It is also important for residents to wash their hands with soap and water regularly and especially before eating and preparing food and after using the bathroom."

Vaccination against hepatitis typically includes two doses.

Health officials are noticing some concerning trends with the rise in cases.

Of the 29 cases confirmed to date in 2025, most have been among people without travel or housing risk factors. Unhoused residents typically are at higher risk because they don't always have access to handwashing and toilets.

Hepatitis A is a highly contagious liver infection spread when people ingest food or drink contaminated by stool from an infected person. Food prepared by the unwashed hands of an infected person can spread the disease.

Symptoms can last a few weeks to several months and can include fever, weakness, fatigue, nausea, loss of appetite, jaundice (yellowing of the skin or eyes), stomach pain, vomiting, dark urine, pale stools and diarrhea.

Although rare, hepatitis A can cause death in some people.

The public health department confirmed 165 hepatitis A cases in LA County in 2024, which is three times the number of cases reported in 2023.

During a news conference via Zoom, Sharon Balter, Director Division of Communicable Disease Control and Prevention, said the county has a new way of disease surveillance by monitoring wastewater. County officials observed a decline in hepatitis A cases in 2024, suggesting the outbreak was getting better since the beginning of 2025, but that has changed.

In 1999, the county introduced a universal hepatitis A vaccine, though it wasn't mandated for school entry. The shot was recommended for anyone born after that year.

"This does mean that there's a large cohort of adults who may not have been vaccinated because they were born afterwards," Balter said. "Some people may not have received the vaccine when they were younger."

According to Prabhu Gounder, a DPH medical director, they have not pinpointed the exact cause of the outbreak. He noted that most people under the age of 25 should be vaccinated and older adults were mostly immune as a result of recurrent epidemics that would happen before the vaccine.

"We have this upper population, which is partly what could be contributing to this increase we see now," Gounder added.

Balter said there have been outbreaks of this magnitude in the past, but not in the last seven years. In 2017, San Diego experienced a significant hepatitis A outbreak, which resulted in 592 cases and 20 deaths, according to San Diego County. The outbreak ended on Jan. 23, 2018.

"We were lucky," Balter said. "Part of that reason, although probably not the only reason, was that we were able to mobilize a tremendous number of resources, nurses and others to go out into the streets."

County officials continue to monitor and investigate suspect cases. The department said it is working with homeless service providers to inform unhoused people about the outbreak, and assist those with symptoms.

People can receive the vaccine soon after exposure to protect against developing the infection.

According to the county, the vaccine series is safe and highly effective in preventing infection. It has been routinely given to children for over a decade. Residents are urged to check if they have been vaccinated for hepatitis A by contacting their medical provider. To protect community health, Public Health strongly encourages vaccination for:

• Any LA County resident who did not previously receive a hepatitis A vaccination and is seeking protection
• People experiencing homelessness
• People who use drugs (including non-injection)

Full protection requires two doses of hepatitis A vaccine administered at least 6 months apart.

For a list of sites offering hepatitis A vaccinations, residents can go to the county health department website. Uninsured or underinsured residents can get vaccinated at county Public Health clinics.

City News Service contributed to this report.