The Hepatitis A outbreak and some thoughts on hygiene

A reporter emailed me yesterday about the deadly Hepatitis A outbreak currently happening in Southern California and asked for my feedback on how this may be happening in the homeless population. There have been 160 confirmed cases and four people have died so far.

Homeless people are at more risk than average and quite a few of these confirmed cases are among homeless people. About 80 percent of the afflicted have had to be hospitalized.

Here are a couple of pertinent articles:
Third Person Dies From Hepatitis A Outbreak In San Diego County(May 5, 2017)
San Diego County Hepatitis A Outbreak Linked To Santa Cruz Strain (June 15, 2017)

Someone had suggested to this reporter that the California plastic bag ban may be related to the outbreak. I think this is plausible. I linked him to a Reddit discussion of how homeless people often use plastic bags to dispose of human waste when they need to relieve themselves under conditions where they have no access to a bathroom, which often occurs at night.

I have never pooped into a plastic bag and dumped it in the trash can. I have been homeless nearly 5.5 years. I am getting healthier on the street, not sicker. I do it by eating carefully and exercising stringent germ control practices and policies because when you are homeless, the best answer is to just not get germy because you face greater than average challenges in getting clean again. Here are some of my germ control practices:


I carry both hand sanitizer and spray peroxide. I use them liberally to keep clean. We particularly use them to clean our hands after peeing or pooping outdoors.

I don't dig in trash cans. When I did recycle, I picked up recyclables from the ground. I usually did not dig in trash cans. When you can't get showered and can't routinely launder your clothes, the best answer is to just not get germy to begin with. There can be no hope of getting it off. If I did pull stuff out of trash cans, I typically changed my shirt afterwards. You can get t-shirts for as little as a dollar from places like the dollar store and Walmart clearance racks.

I have always camped in areas with greenery, even when I was in downtown San Diego. I have never slept in an alleyway behind a dumpster or anything like that.

I make sure I know where all the public bathrooms are and I also find bathrooms in stores where I shop regularly. I do my best to not defecate outdoors. I do pee outdoors routinely, but I do my best to defecate in proper facilities and then wash up afterwards.

When I get new clothes, I try to clean up and throw the old ones out when I change.

I carry disposable plastic cups and I never share germs with someone else when sharing a drink with them. I am homeless with my two adult sons and we never drink from the same cup or bottle. We pour drinks into cups and throw the cups out after we are done. This is a small expense that goes a long way to protect us from communicable disease.


After the exchange with the reporter and discussing this issue with my two sons, I suspect homeless people are digging plastic bags out of trash cans to get them for free. They no doubt use them for various purposes, possibly including disposing of poop.

Please do not dig plastic bags out of trash cans to use for any purpose. If you get food stamps, you are exempt from paying for plastic bags. You can get your bags for free.

I realize the bag ban is just one more "fuck you, homeless people" policy. I would have voted against it had I managed to vote, but being homeless got in the way. I realize that germ control on the street is a huge challenge and that the list of practices here probably sounds quite challenging. It isn't even comprehensive. There are other things I do to control germs.

But homeless people have a lot of health problems and being homeless can have a terrible negative effect on your health. If you are to have any hope of getting your life back, you need to practice strict germ control.

With getting gradually healthier, my freelance income is going up. I have also paid off debts while homeless. I hope to get back into housing in the next few months. This would not be true if I were not very careful about germ control.