So Others May Eat holds Hep A forum: County says of 536 cases, 172 stricken were homeless and/or drug users


In preparation for the annual feeding programs for those in need held toward the end of the year at Mary, Star of the Sea Catholic Church on Girard Avenue (in addition to ongoing bi-weekly dinners) the non-profit group, So Others May Eat (SOME), hosted a forum about Hepatitis A on Nov. 2 at the church.

The speakers were Jamie Felice, San Diego County senior public health nurse, and Roberto Ramirez, Community Health Promotion Team member. They were invited to dispel myths about Hep A and its relationship to homelessness.

Thus far, there have been 536 confirmed cases of Hepatitis A in San Diego County and 20 deaths. Of the confirmed cases, about 30 percent were spread among San Diego’s homeless population and drug-users (or both) due to lack of sanitation options.

In running down some facts, Ramirez said the incubation period (from exposure to symptoms) is about 28 days, but that can vary from 15 to 50 days, and the virus can live outside of the body for several months.

“It is easily spread from person to person through fecal bacteria. You have to touch a surface that is contaminated and then put your hands in your mouth to get Hepatitis A,” he explained. “Hep A can last a few weeks to a few months. For those with underlying health conditions, the impacts can be severe. Some of the deaths we see in the County have been because the victims had underlying medical conditions that prevented them from recovering.

“We want to stress that Hep A is not a homeless issue, but a sanitation issue. We need be cognizant that just because we see a homeless individual on the street, that does not mean he or she has Hep A. It’s hand hygiene that prevents the spread.”

He said routine hand-washing for at least 20 seconds will reduce the risk of contracting Hepatitis A, and to make sure your hand-washing time is sufficient, sing “Happy Birthday” twice.

“People ask whether the water temperature makes a difference, but that’s not necessarily the case. Your hands cannot withstand 185-degree water (the temperature that kills the virus), you’re not meant for that. But washing for 20 seconds takes care of that,” Ramirez insisted.

Felice, hoping to dispel the perception that it’s only homeless people who spread Hep A, pointed out that there are “significant numbers” of substance-abusers with the affliction. “We have an opioid epidemic and that is where we’re seeing the outbreak primarily,” she said, reminding that opioids can be injected and smoked.

Ramirez cited smokers as an example: “They might not wash their hands adequately and might have that fecal matter contamination. If they touch their cigarette, put it to their mouth, share that cigarette with someone, then that fecal matter traveled from their hand to their mouth and to another person.”

By the numbers

Of the 536 confirmed Hep A cases, 172 were homeless and/or drug users; 86 were homeless only, 64 were drug-users only, Felice said. Despite the findings, some forum attendees were still uncomfortable with SOME’s free meals program, which they feel brings homeless people into La Jolla.

“This is the church that feeds homeless people in La Jolla,” said resident Cynthia Chasan, who is also the La Jolla Town Council Community Watch Committee co-chair. “And if these people are not properly washing their hands, they can bring this virus into our community.”

In response, SOME founder Tresha Souza said she was raised to “help people in need” and that’s why she hosts the meals program. “These people need help more than ever,” she said. “What we’re lacking here, is compassion. We have the knowledge to wash our hands and sing Happy Birthday twice.”

SOME provides meals every other Thursday at Mary Star of the Sea, and volunteers often create take-home meals for guests. SOME also offers a mobile food pantry. Souza explained: “our patrons consist of homeless individuals, elderly adults, and families and individuals who have homes but are having a hard time financially. We accept anyone who needs assistance.”

When possible, Felice said she brings vaccines to those that come to the feeding program.

Ramirez added, “We’re trying to reduce the number of infections, but there are underlying issues correlated to this outbreak. In public health, we know there is a difference between correlation and causation. Just because a homeless person has Hep A does not mean homelessness (spreads) Hep A.”