Declared a public health emergency on Sept. 1, a hepatitis A outbreak in California is only getting worse, the Los Angeles Times reports. There have been 421 confirmed cases of hepatitis A in San Diego County, and 292 people have been hospitalized. Sixteen people have died. The county has vaccinated 19,000 people, and on Monday workers started spraying sidewalks and and streets in downtown San Diego with bleach-infused water to kill the virus, according to the San Diego Union-Tribune.
Hepatitis A can be spread when people don't wash their hands properly after going to the bathroom. The current outbreak has hit San Diego's homeless population hardest. The county is installing 40 hand-washing stations where homeless people congregate and is making some public restrooms available 24 hours a day. KGTV reports San Diego will be opening three temporary homeless shelters that, along with beds, will have restrooms and showers. Officials warn it could be months before these new measures show any positive effect on the outbreak. (Read more hepatitis A stories.)