Hepatitis A Outbreak Among Persons Experiencing Homelessness — Maricopa County, Arizona, 2017
- During the spring of 2017, the Maricopa County Department of Public Health identified and controlled an outbreak of 15 cases of hepatitis A among adults experiencing homelessness. The majority of patients accessed food, shelter, healthcare, or social services at a centralized campus. The outbreak highlighted the sanitation and hygiene challenges faced by persons experiencing homelessness, and that this population might benefit from routine vaccination against hepatitis A.
- The outbreak was likely spread from person-to-person through contact with surfaces and hands contaminated by microscopic amounts of feces. To stop the spread, the Maricopa County Department of Public Health partnered with the campus to distribute hand-hygiene products, and offered the hepatitis A vaccine to people at risk.
- Existing partnerships with local agencies and healthcare providers that serve people experiencing homelessness were critical for a rapid response. The public health team provided an onsite education and vaccine clinic within one week of when the outbreak was identified. These relationships and early, targeted response were key to stopping the outbreak.
- The CDC laboratory linked the outbreak strain to the San Diego outbreak, where the index patient had lived before coming to Maricopa County.
“Public health’s existing partnerships with organizations that serve people experiencing homelessness were key to this rapid and successful outbreak response.”
-Sally Ann Iverson, DVM, MPH, EIS Class of 2016
[PNG - 626 KB]Sally Ann Iverson, DVM, MPH, EIS Class of 2016, prepares to interview vaccination clinic participants during a 2017 outbreak of Hepatitis A among people experiencing homelessness in Maricopa County, Arizona.
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Sally Ann Iverson, DVM, MPH, EIS Class of 2016
Arizona Department of Health Services
Education: MPH: Johns Hopkins University, 2012; DVM: Cornell University, 2011; BS: University of Miami, 2007
Work Experience: Veterinary Medical Officer, Foreign Animal Disease Diagnostic Laboratory; Office of the Director (Chief of Staff), U.S. Deptarment of Agriculture, Animal/Plant Health Inspectorate Service, Greenport, CT, 2015-Present; Veternarian Medical Officer, North American Foot-and-Mouth Disease Vaccine Bank, U.S. Deptartment of Agriculture, Animal/Plant Health Inspectorate Service, Greenport, NY, 2013-2015; Student Research Assistant, Cornell University College of Veterinary Medical Cardio Department, Ithaca, NY, 2008-2008
Volunteer Experience: Volunteer Horse Handler/Leader, High Hopes Therapy Riding Center, Old Lyme, CT, 2013-Present; Volunteer Veternarian/MPH Student Maryland Department of Health and Mental Hygiene, Baltimore, Maryland, 2012-2012