SAN DIEGO -- The Board of Supervisors voted in a special meeting Tuesday to extend a state of emergency over a deadly outbreak of hepatitis A in San Diego County.
The board is required to renew emergency declarations every two weeks, but its next regularly scheduled meeting isn't until Jan. 9.
As of Tuesday, there have been 577 reported hepatitis A cases linked to the outbreak, the start of which was traced back to November 2016.
The rate of new infections has slowed in recent months: From May to September there was an average of 84 cases per month. There were seven cases last month, according to county health officials.
Of those sickened by the disease, which attacks the liver, 20 have died, but none recently.
Officials in the coming weeks will consider ending the emergency declaration by looking at what the new "status quo" for hepatitis is in the county.
Residents in the region who contracted the disease in the past would often become infected while traveling abroad. The new normal could mean that there is some risk of contracting the disease here too, said Dr. Nick Yphantides, the county's chief medical officer.
"I don't know if we're ever going to go back to where we were," he said.
Hepatitis A usually is transmitted by touching objects or eating food that someone with the virus has handled or by having sex with an infected person.
The disease doesn't always cause symptoms but can cause fever, fatigue, nausea, loss of appetite, yellowing of the eyes, stomach pain, vomiting, dark urine, pale stools and diarrhea, according to the HHSA.
The county and city governments took several steps to address the outbreak, including the spraying of a sanitizing formula on streets and sidewalks, the placement of portable hand-washing stations and restrooms in areas where the homeless congregate and a stepped-up immunization campaign.