Health officials in San Francisco are ramping up vaccinations in response to hepatitis A outbreaks in Southern California.
San Diego's deadly hepatitis outbreak is spreading. The infection has been reported in Los Angeles and in the Bay Area, with 69 cases reported in Santa Cruz County. On Tuesday morning, officials in LA reported 10 cases of the exact same strain.
In all three places the outbreaks start out concentrated in homeless encampments. Hepatitis A is commonly transmitted from the human waste of an infected person to the mouth of the disease's next victim. At homeless camps where there are no available bathrooms, the disease is finding a foothold.
At a San Francisco homeless camp near Cesar Chavez and Highway 101, Caltrans and California Highway Patrol crews clean up human waste and drug needles twice a week.
"It's not an area where you would want to be walking around," said Vu Williams with the CHP. "It's not an area where you would want to be walking around."
Campers tell NBC Bay Area they are using bleach to wash the sidewalks.
In San Diego, crews are washing streets with bleach. They are setting up portable hand washing stations, with 421 cases and 16 deaths. The county wants every food service worker at every restaurant vaccinated for hepatitis A.
Meanwhile, tourists are avoiding the downtown area for fear of being exposed.
Public health nurse Kate Shuton is vaccinating homeless people at a shelter in San Francisco's Dogpatch neighborhood. Staffers are also lining up.
The health department started ramping up their vaccinations in response to the San Diego outbreak, but the numbers being vaccinated are still small compared to the number of homeless on the street.
Shuton said hepatitis A is easy to combat if your vaccinated and easy to contract if you're exposed.
Public health officials in the Bay Area are relying on vaccinations and said they do not have the resources to provide toilets and hand-washing stations in the streets. While there are no official numbers provided Tuesday, there's no question there are many more homeless people that have not been vaccinated than those who have.