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Post Info TOPIC: Up-surge of Hep A in California


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RE: Up-surge of Hep A in California
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Helio - News

Patients with HBV, HCV should receive hepatitis A vaccination



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HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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Helio - News

Hepatitis A cases spike among drug users, homeless

Since November 2017, Kentucky has seen a spike in reported hepatitis A cases, which has led to higher than average mortality rates among people with prior health conditions, including people who use drugs, according to the CDC.

"Although rare, hepatitis A can cause death in some people - such as people over 50 and people with other liver diseases," the CDC told†Infectious Disease News.

Although the all-age mortality rate for hepatitis A is 0.6%, a higher burden has been observed among the homeless population and among those who use injection and noninjection drugs in the state.

According to the Kentucky Department for Public Health, there have been 448 cases of hepatitis A, with 315 hospitalizations and four deaths since November 2017. Some of the cases identified in Kentucky have been linked through viral sequencing to the†outbreaks that occurred in California†and†Utah.

Indiana has also observed an increase in hepatitis A cases, particularly among injection drug users, since November 2017. Currently, Indiana has 91 reported hepatitis A cases, with 44 hospitalizations and no deaths. On average, the state observes approximately 20 hepatitis cases a year. Indiana health officials said the spike in hepatitis A cases in southern Indiana may be linked to the Louisville, Kentucky, outbreak.

Since 1995, the contagious liver infection has been a vaccine-preventable disease, and the national CDC hepatitis A guidelines recommend that children aged younger than 1 year, among other at-risk groups, receive the vaccination. However, the CDC has not issued a specific recommendation for†hepatitis A vaccination†among all adults living in Kentucky or Indiana.

"State and local health departments in the affected areas are prioritizing vaccination to individuals at highest risk of acquiring infection, including injection/noninjection drug users, men who have sex with men, persons in transient living conditions, recently incarcerated persons and individuals with chronic liver disease," the CDC told†Infectious Disease News.

According to a press release issued by the Louisville Metro Office of Public Health and Wellness, a White Castle employee has been diagnosed with hepatitis A. Anyone who ate at the establishment located at 3701 Seventh St. Road in Louisville between April 6 and April 20, may have been exposed to the hepatitis A virus.

Working in conjunction with the University of Louisville Global Health Center, the Louisville Metro Office of Public Health and Wellness is providing vaccines to people who work in hospitality at a reduced cost of $25, according to the release.

"As soon as we became aware [of the hepatitis A exposure], we worked with the health department and did offer vaccines to all of our team members in the Louisville region,"†Jamie Richardson, vice president of White Castle told†Infectious Disease†News. "As a family-owned business, our number one priority is the safety of our team members and of our guests."



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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Apr 11, 2018 update on Calif. hep A outbreak: 704 cases, 21 deaths. Only 4 new cases, no new deaths. Public Health has deemed a slow-down in this area and will not be routinely providing further updates.

Apr 25, 2018 update on Michigan hep A outbreak: 821 cases, 25 deaths. Up by 50 new cases, no new deaths.†

California seemed the first to peak in the hep A outbreaks, and the first to slow, in relation to Michigans outbreak. But there are other outbreaks in other States going on as well, such as Kentucky, Utah, Indiana.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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More updates on Hep A outbreaks:

Michigan - Feb 28 update - 771 cases, 25 deaths. Up by 44 new cases, 1 new death. (Prior - 727 cases and 24 deaths).†

Calif - Feb 23 update - 700 cases, 21 deaths. Up by 11 cases, no new deaths. (Prior - 689 cases and 21 deaths).

Calif seemed to peak sooner than Michigan, both Michigan and Calif. quieted some with winter. Waiting to see if there are again upsurges come Spring and Summer weather, with bodies mobilizing/migrating, and in consideration of the effectiveness of whatever steps/measures States/Counties and CDC have taken, to get a handle on these outbreaks.†



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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Hm, sorry. Looking back at the two links I pasted? (on Feb 1 and the next that said 2 days ago) ... I don't recall employing use of "word" to do that - I think I just copied and pasted the links directly from what I was "in and reading", but ... cannot be sure now - but don't think any use of "word" was involved?

Sometimes I think a cloud of computer glitch just follows me around like a malevolent ghost! My techno handicaps inconvenience me and those around me I am afraid.

Speaking of ghosts, in the Calif outbreak thing, they are speculating there has been a bit of a plateau, where as in the Michigan one (which you brought to my attention) it seems to be lagging a bit behind and is in the more peaking mode (there are a lot of contributory variables). Come spring, we may see the Calif one continuing perhaps at a lower more steady level? despite some good efforts to quell the spread. Michigan has been vaccinating like mad too, creatively and conveniently using the prison/detentions center systems there to innoculate at least about 4000+ people against Hep A. Hope all the states can do enough to knock this spread down as it seems to be a nasty variety of Hep A (all on it's own - jmo). The added negative influences the afflicted groups face (disadvantaged/lower socio-economic groups, those with prior hep/health issues, and just in general poor health/conditions anyway), is a perfect storm resulting in this awful loss of life and suffering!



-- Edited by Canuck on Sunday 4th of February 2018 01:39:05 AM

__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)

Tig


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It was the info on 2/1 that was causing it to jump around on mobile devices. Did you clip and post or use Word to insert that bit of text? The forum software doesnít compensate for the length or format of some additions like that. Word is a culprit sometimes. I usually find it and fix it, but sometimes it takes trial and error searching!†



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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Tig,

Nope, looks fine to me, dunt see nuttin funny, ie no scrolling or jumping on my end. Weird things eh? C.†



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)

Tig


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Is anyone else having trouble viewing this thread? The page is auto scrolling (bouncing up and down)†



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ† †Lab Ref. Ranges

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More updates on Hep A outbreaks:

Michigan - update from this week - 727 cases, 24 deaths. (Prior 658 cases and 22 deaths - up by 69 new cases, 2 new deaths).

Calif - update from last week - 689 cases, 21 deaths. (Up by 6 new cases).



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)

Tig


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It really looks like this unfortunate situation is gaining speed versus slowing down. Iím afraid people with chronic Hep B +/- C and letís not forget HIV, that develop Hep A are going to really suffer significant illness and damage. I think itís vital to get healthcare teams and mobile lab testing into these areas, in abundance!

We as a group have the loudest voices in this battle. Let your voice be heard, be it by phone or message, just do it. Our local governments need to know that this is important. Resources are provided to the squeakiest wheel. Remember there are far more people that donít know they are infected with Hep C than do. The CDC says there is an annual number of 17,000 confirmed new HCV cases and because people donít know, or their infections go unreported, the number may be closer to 30,000. †Staggering....



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ† †Lab Ref. Ranges

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Tig found this, it can also be found over in†HCV Advocate Monthly Report†.†



-- Edited by Tig on Saturday 3rd of February 2018 10:11:51 AM

Attachments
__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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Update:

Overall numbers up somewhat (since last article of Oct 5).

Dec 29 - 21 deaths.

Hep A Outbreak/Immunization



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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Update:

Hm, this news article is old (Oct 5, 2017), so, the numbers could be a bit "off", we can assume the numbers might be higher by now - I'll keep searching for a more "up-to-date" tally on the "small" Hep A epidemic in California.

Last news story (scroll down to Jul 25 post) the count was only (aprox) 275 people, and only 5 deaths, the outbreak confined to 2 areas.

The Oct article I post today, although not current, is still an interesting read, what with the experts "forecasts"/prognosis on this "outbreak". How long will it last, how far will it spread before it is finished. Note†how almost ALL the deaths(up to 17 now) from this Hep A up-surge occured to the unfortunate folk who were already packing another kind of hepatitis! Just stands to reason, catching Hep A on top of having chronic Hep C, or on top of having chronic Hep B (or on top of being in any already liver-compromised state) can be fatal, just one too many insults (or hepatitises) for that persons poor liver and body to withstand.

Smaller clusters of Hep A have splintered off, now travelling? Total possible California cases 569 (at this Oct article date)? Most of these being in San Diego County, but about 90 of these cases showed up elsewhere, (in order of highest incidence) - Santa Cruz Country, L.A. County, and other unspecified places in California. It seems "most" of the more distant cases (non-San Diego), have been deemed to be related to/tracked back to the original San Diego outbreak.

A lot of immunizations have recently occurred in the hottest spots, good on public health - San Diego/Santa Cruz/Orange County, these spots and other places around are boning up and/or reviewing their prevention tactics, much talk on the Hep A topic is going on in places like Venice/San Francisco/ Oakland/ Sacramento/ Riverside.

http://www.latimes.com/local/california/la-me-ln-hepatitis-outbreaks-20171006-htmlstory.html



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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Canuck wrote:

ya! eww. Oh well, I guess ya gotta do what you gotta doo. C.


†Yeah, literally the whole town was 4 feet deep in water, and nothing like being at the mouth of a river, on a sand bar, with no power in a country that has no civil defense other than some 19 year kids with machine guns in the back of the Jefe's pickup truck.†

When the sun went down on the 2nd day of the cat 4 storm, the wind was at 175 sustained with intense gusts that were spinning cars around and sailing palapa roofs like tiddley winks... then, hep A, cholera and well, time to go home!



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Lamont Cranston "Only the Shadow knows."

65 years old, retired IT Network support 29 continuous sobriety in AA, ,DX'd in '99 with MS, DX'd with HCV 2, 2b , F0-F1 3/17/2017 VL 5.7m Starting EPCLUSA 7/28/17

No Virus Detected on†November 20, 2017 3 months after EOT



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ya! eww. Oh well, I guess ya gotta do what you gotta doo. C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)

Tig


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"The culture of fecal coliforms from marijuana confiscated during one investigation (Alaska Department of Health and Social Services, unpublished data) raises the possibility that direct contamination of drugs could be a factor in some of these outbreaks."

OH MY!!!



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ† †Lab Ref. Ranges

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Hep A is the nastiest thing I have ever had the misfortune of acquiring. Getting "vaccinated" the old-fashioned way is Not Fun. I ran a

high fever for about 2.5 weeks, and was down for almost 6 months total. Nasty!

I got mine in Mexico during a hurricane, when the town I was living in flooded and well, you can imagine in a place that has no real sewage treatment. The Whole Dam Town was sick a few weeks later!



-- Edited by LamontCranston on Tuesday 25th of July 2017 08:05:27 PM

__________________

Lamont Cranston "Only the Shadow knows."

65 years old, retired IT Network support 29 continuous sobriety in AA, ,DX'd in '99 with MS, DX'd with HCV 2, 2b , F0-F1 3/17/2017 VL 5.7m Starting EPCLUSA 7/28/17

No Virus Detected on†November 20, 2017 3 months after EOT



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Tig,

The article DID say ...†this outbreak is different from most of the prior outbreaks because it is a result of person-to-person transmission and not caused by a contaminated product," the CDPH representative said. "The population affected are persons who are homeless and/or report drug use."...

(Very easily we could be seeing a group of people who are injecting/innoculating themselves with direct hits of hep A). By "blood" and/or by "association" could be possibilites ... here is an old article exerpt attesting to blood methods of hep A contraction.

...†Two possible explanations for the association between hepatitis A and drug use have been proposed: 1) HAV may be transmitted by injection or ingestion** of contaminated drugs (common-source spread), or 2) transmission may result from direct person-to-person contact. The culture of fecal coliforms from marijuana confiscated during one investigation (Alaska Department of Health and Social Services, unpublished data) raises the possibility that direct contamination of drugs could be a factor in some of these outbreaks.*** Drugs could become contaminated with fecal material containing HAV at the cultivation site (e.g., through use of human feces as fertilizer) or during transport, preparation, or distribution (e.g., through smuggling in condoms concealed in the rectum (4) or in baby diapers). However, the pattern of occurrence of the cases by dates of onset in each of the outbreaks and the diversity of drugs involved argue against a single common-source mode of transmission. Nevertheless, sustained common-source transmission is possible if contaminated drugs were distributed among persons who then used them at different times.

Person-to-person transmission of HAV between drug abusers could result from sharing needles, from sexual contact, or from generally poor sanitary and personal hygiene conditions, which have often been observed among drug abusers. Isolated instances of bloodborne transmission resulting from transfusions from donors who had given blood during the incubation period of viral infection have been reported. Due to the relatively short viremic phase of HAV infection, however, bloodborne transmission through needle-sharing is unlikely to have sustained large outbreaks such as those reported here, although it may have accounted for one cluster in Cortland County ...

I only posted the first news article, merely, because it is always a good idea (and a reminder), for ANY person with an existing compromised liver status, (HCV or otherwise) to be immunized against other liver infections such a hep A or B (or even just the flu for that matter), if it could possibly prevent them from gaining even more trouble (on top of what liver troubles they already have).

Iris, I'm glad you posted here - I keep missing you, I see you post off and on, here and there, and I fret about you not being treated for your HCV. You SHOULD be immunized for A and B and flu. Not only that .... but please see my last post to you over in "Maybe not sick enough".†smile†C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)



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I didn't realize there was a hep A vaccine, and I have been reluctant to get the B vaccine. I wash my hands all the time in the last several years...to the point I feel obsessive compulsive, and that feels crazy to me. Yet I have had fewer colds and flu.†

This is disturbing, being I live in Cali.

Bb, Iris



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in the silence of the woods, you will not be alone- Chief Seattle

59 years on planet, Female, diagnosed 1978 as non-a non-b, VL 8mill+, Fibro f-1f-2, Genotype 1a, treatment naÔve....UNTIL 7-01-18† !!!! started Harvoni 12 weeks. :)

Tig


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California has a huge migrant and homeless population. I'm curious what the breakdown in those numbers are. Sanitary conditions are generally responsible for HAV outbreaks. It's typically spread through food and water consumption of infected feces. Yum... doh†I would be interested in knowing how many cases were distributed between agricultural and restaurant workers and customers.

The number of deaths and hospitalizations, not to mention the combined numbers of infections should really be worrying for state epidemiologists. This is one form of hepatitis that can really get out of hand quickly. (Obviously) HAV rarely results in hospital admissions, so that number alone is startling. It's usually a form of hepatitis that resolves on it's own, so these cases, again, are alarming. One infected individual can wreak havoc when sanitary precautions aren't instituted and followed.†



__________________

Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ† †Lab Ref. Ranges

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California health officials battle state's largest hepatitis A outbreak in 2 decades

Helio - July 21, 2017

The California Department of Public Health is working with local health officials in San Diego and Santa Cruz counties to contain the state's largest hepatitis A outbreak in 2 decades.

As of July 18, officials identified 251 cases and five deaths in San Diego, and 27 cases in Santa Cruz since the outbreak began in November, according to the California Department of Public Health (CDPH). San Diego's Health and Human Services Agency reported that 69% of cases in the county required hospitalization.

A CDPH representative told†Infectious Disease Newsthat the overall case count is larger than that of all other hepatitis A outbreaks in California combined over the past 20 years. There were seven hepatitis A outbreaks in the state from 1998 to 2015, totaling 224 cases and one death.

"In addition to being the largest, this outbreak is different from most of the prior outbreaks because it is a result of person-to-person transmission and not caused by a contaminated product," the CDPH representative said. "The population affected are persons who are homeless and/or report drug use."

The CDPH said it will continue to provide technical assistance and hepatitis A vaccines to affected populations in San Diego and Santa Cruz.

"CDPH has issued statewide guidance regarding which groups of people to target for hepatitis A vaccination," the CDPH representative said. "The homeless/drug-using population is very difficult to access for vaccination, so this guidance has been shared with community health care providers and also with emergency rooms, jails and organizations that work with homeless persons and/or drug users."

The†hepatitis A vaccine†is routinely recommended for children,†travelers to countries with higher rates of hepatitis A, homeless people, men who have sex with men, individuals with chronic liver diseases and household or sexual contacts of patients with hepatitis A. However, many adults have not been vaccinated against hepatitis A and are susceptible to infection, according to the San Diego health department. Because the outbreak largely affects homeless individuals and drug users, health officials recommend that unvaccinated workers and volunteers who interact with these populations be vaccinated. They are also urging people to practice good hygiene to avoid infection.

"It is imperative that anyone at risk for hepatitis A get vaccinated,"†Wilma Wooten, MD, MPH,†San Diego County public health officer, said in a press release. "We cannot stress this enough: Get vaccinated and make sure you wash your hands after going to the bathroom. Lives are at risk. Protect yourself, your family and the community." -††by Stephanie Viguers



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

(SEE UPDATES IN BIO)

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