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‘Patient zero’ in deadly San Diego hepatitis outbreak is homeless man from El Cajon area, officials say

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As San Diego’s hepatitis A outbreak has continued to grow, so has a fascination about the identity and importance of “patient zero,” the first person believed to be infected in a surge of illness that has now killed 19 people.

At first unwilling to say much about this mysterious person, San Diego County health officials disclosed twice during public meetings in late September that the apparent first patient — what epidemiologists often call an outbreak’s “index case” — was a homeless man who tested positive for hepatitis infection in East County.

Dr. Eric McDonald, chief of the county’s Epidemiology and Immunization Services Branch, reiterated in an email this week that this man was treated in a La Mesa hospital and “when interviewed said that the exposure period was mainly in El Cajon.”

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Further details on exactly where in El Cajon, and where else patient zero might have lived, have not been forthcoming and a lack of genetic analysis due to his unknown whereabouts have made absolute confirmation of his first-patient status impossible.

Though most of the outreach and sanitation efforts have focused on the city of San Diego, and a recently released list of cases by ZIP code shows that the largest number of cases occurred downtown, some have taken note that the current public health crisis may have started somewhere else.

“Patient zero coming from a different part of the county speaks to how we need to have every part of the community stepping up to solve this problem,” said James Haug, a downtown condo owner and president of the East Village Assn., a business improvement district.

There’s been at least a small impact on downtown business: A cookie convention slated to hold its event at the San Diego Convention Center in September chose to withdraw until the outbreak is deemed over, though local officials challenged whether hepatitis was the true rationale.

Michael Trimble, executive director of the Gaslamp Quarter business association, said there’s no hard evidence that there’s been an effect on business.

“It’s definitely on everyone’s mind,” he said. “I’m sure there are some people who just won’t come downtown because of hep A, but I’m looking out my window right now and seeing two families with their kids strolling down 5th Avenue.”

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While he said it’s “good to know” that the first patient may have been in East County, downtown still has a large population of homeless people and it’s important to continue getting that at-risk population immunized against the virus.

Paul Sisson and Jeanette Steele write for the San Diego Union Tribune.

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