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What to Know About the Hepatitis A Outbreak in L.A. County

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What to Know About the Hepatitis A Outbreak in L.A. County

Public health officials in Los Angeles County have declared an outbreak of hepatitis A, a highly contagious liver infection driven by a virus that can, in rare cases, cause severe illness.

The condition, which is typically identified in fewer than 50 people in L.A. County each year, infected at least 138 people in 2024 and cases have remained unusually high so far in 2025. Officials say that levels of the virus in local wastewater suggest these figures are an undercount.

Here’s what to know.

The hepatitis A virus is spread through the so-called oral-fecal route, which means it is ingested through food or drinks that have been contaminated by microscopic bits of stool from an infected person. It can also spread through close contact with someone who is carrying the virus, even if they don’t show any symptoms.

Unhoused people are often at greater risk of contracting hepatitis A because they have limited access to proper toilets and hand-washing facilities. The virus is also more common among travelers to places with poor sanitation, men who have sex with men and people who use drugs.

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But officials say many of the recent cases have occurred in people without those risk factors. They do not yet know why, but Dr. Timothy Brewer, an infectious disease physician and epidemiologist at U.C.L.A., said it had led him to worry about two things: food contamination, and community circulation.

“If you’re practicing good hygiene in a community that has access to potable water, you really should not be seeing a lot of this,” he said. “Something is going on — but exactly what that something is, we don’t yet know.”

The first signs of the infection can look a lot like a classic stomach bug: fever, fatigue, nausea and a loss of appetite, followed by vomiting and diarrhea. Over time, people who become infected can also experience yellowed skin and eyes, dark urine and pale stools.

One of the challenges to halting a hepatitis A outbreak is that contact tracing can be nearly impossible. The infection can incubate for up to seven weeks before symptoms appear, and a person carrying the virus can spread it for up to two weeks before they feel ill.

In addition, a significant proportion of people who become infected don’t experience major symptoms, said Dr. Edward Jones-Lopez, an infectious disease specialist with Keck Medicine of the University of Southern California, so they do not visit their doctor, who in turn does not run a blood test and report the case.

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Severe symptoms are most often seen in older adults, people with chronic liver conditions, and those with weakened immune systems or H.I.V. On rare occasions, a hepatitis A infection can be fatal. In this outbreak, at least seven people have died. That may seem like an unusually high fatality rate, but officials believe far more people have been infected than the official numbers show. Most have probably been asymptomatic, or shown symptoms mild enough to have been misidentified.

There is no specific antiviral medication for hepatitis A. The infection usually resolves on its own within a few weeks, and most people do not face lasting liver damage. But for some, hospitalization can be necessary.

In rare cases, the infection can devolve into an acute liver failure called fulminant hepatitis, which may require a transplant, said Dr. Jones-Lopez. “It can progress very, very quickly — that’s a very serious disease.”

If you think you might be infected, be sure to visit your doctor, drink lots of fluids, and get adequate rest.

The best way to prevent a hepatitis A infection is through vaccination. The regimen — two doses of vaccine, at least six months apart — provides protection for life. It has been routinely given to children for the last two decades, but many adults 25 and older have not gotten the shots unless they were in a high-risk group.

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The fact that the outbreak is occurring outside of traditional populations “underscores the need to reassess how — and where — we target prevention efforts,” said Dr. Anne Rimoin, an epidemiology professor at U.C.L.A., since “an infection anywhere is potentially an infection everywhere.”

If you are unvaccinated but know you have been exposed to a person carrying the virus, a prompt vaccination can prevent your becoming infected. Experts say that some people with weakened immune systems who are exposed could also benefit from receiving immune globulin as well. And good hygiene is a wise protective measure for everyone; wash your hands with soap and water, especially after using the bathroom, and before preparing food.

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A Near-Full ‘Strawberry Moon’ Will Shine Again on Wednesday Night

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A Near-Full ‘Strawberry Moon’ Will Shine Again on Wednesday Night

Night sky observers are being treated this week to a view of a red-tinted full moon — known in June as a “strawberry moon” — a phenomenon that occurs when the moon sits low on the Southern Horizon.

This summer, the reddish color is particularly pronounced because the moon is sitting at the lowest position it will reach for about 19 years.

The strawberry moon’s colorful hues were visible Tuesday night, and it reached its brightest point Wednesday around 4 a.m. Eastern time.

Here’s what it looked like:

According to folklore, the name “strawberry moon” came from Algonquin Native American tribes to commemorate strawberry gathering season. Another name for the full moon in June is “rose moon,” which may have come from Europe.

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“Most of the traditional names we use seem to come from Native American usage, but some are clearly European in origin, like the one in December, called ‘the moon before yule,’ a reference to Christmas,” said James Lattis, a historian of astronomy at the University of Wisconsin-Madison.

Summer full moons are always low relative to winter full moons in the Northern Hemisphere, and therefore are more reddish in color, Dr. Lattis said. That’s because viewing the moon through the atmosphere gives it a reddish hue, much like the colors visible during a sunrise or sunset, he said.

“If one looks straight up into the sky, there’s less atmosphere,” he said. “If you’re looking through the horizon, you’re looking through the most atmosphere.”

Dr. Lattis said that he had viewed the moon on Tuesday night in Wisconsin, and that it was notable for the pinkish hue it had from smoke in the air from wildfires. He said the sight may not be as dramatic elsewhere.

“I hate to discourage anybody from going out and looking at the moon — it’s a wonderful thing to do, and a lot of times, if you don’t give somebody a reason, they’ll never do it,” he said. “But it’s just another full moon.”

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Democrats Grill N.I.H. Leader on Cuts: Who Is Calling the Shots?

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Democrats Grill N.I.H. Leader on Cuts: Who Is Calling the Shots?

As the Trump administration clamped down on the country’s medical research funding apparatus in recent months, scientists and administrators at the National Institutes of Health often privately wondered how much autonomy the agency’s director, Dr. Jay Bhattacharya, had.

After all, the Department of Government Efficiency, Elon Musk’s signature cost-cutting project, helped drive decisions to cancel or delay research grants. Other projects fell victim to President Trump’s face-off with universities over antisemitism. But given an opportunity before a Senate panel on Tuesday to dispel suspicions about who wields influence at the N.I.H., Dr. Bhattacharya did little to claim ownership of perhaps the rockiest period in the agency’s many decades of funding research institutions.

Decisions to freeze grant payments to Northwestern University “happened before I got into office,” Dr. Bhattacharya told the panel, members of the Senate Appropriations Committee.

He repeatedly said a proposal to shrink the N.I.H. budget by $18 billion — nearly 40 percent — was “a collaboration between Congress and the administration” and declined to talk in detail about how the cuts would affect the agency.

And pressed on an effort to curtail funding to universities for research overhead expenses — a cost-cutting move that is baked into the administration’s 2026 budget proposal — Dr. Bhattacharya said, “I don’t want to get into that,” citing ongoing litigation.

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Several Democrats on the committee said they were confused about who was pulling the strings at the agency.

“I want to know, who is withholding this funding?” demanded Senator Tammy Baldwin of Wisconsin, a Democrat, citing evidence that the N.I.H. had distributed billions of dollars less in grants so far this year than in the same period last year. “Is it you? Is it DOGE? Is it O.M.B.?” she added, referring to the Office of Management and Budget. “Who is making those decisions?”

Dr. Bhattacharya responded, “There’s a range of decisions, I think, that led to some of those pauses of grants.” He said, for example, that it had been his call to move away from what he called “politicized science,” a term he has used in the past to describe research related to diversity and equity issues. But he said that restrictions on research funding at Harvard and other leading institutions had been “joint with the administration.”

Senator Dick Durbin of Illinois, another Democrat, reacted sharply after Dr. Bhattacharya denied responsibility for the administration’s freezing research payments to Northwestern.

An email from an N.I.H. official in mid-April, weeks after Dr. Bhattacharya’s confirmation, directed employees not to issue grant awards to Northwestern and several other universities and not to tell the institutions why their funding had been frozen.

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“The buck stops in your office,” Mr. Durbin told Dr. Bhattacharya. “Don’t blame another person.”

The Trump administration’s effort to significantly shrink the agency’s spending next year drew criticism from senators of both parties, including Senator Susan Collins of Maine, a Republican.

The proposed reduction “is so disturbing,” she told Dr. Bhattacharya. “It would delay or stop effective treatments and cures from being developed for diseases like Alzheimer’s, cancer, Type 1 diabetes.” The plans, she said, put the United States at risk of “falling behind China.”

Dr. Bhattacharya said that the N.I.H. was committed to research on Alzheimer’s and other diseases and that he would work with lawmakers to address “the health needs of all Americans.”

The director did open the door to an agreement between the Trump administration and leading universities that would unfreeze their medical research funding, although he offered no details about the prospects for such an agreement or what it would take to arrive at one. “I’m very hopeful that a resolution can be made with the universities where those grants have been paused,” he said.

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The N.I.H. in recent months has abruptly ended more than 1,300 grant awards and delayed funding for more than 1,000 other projects. On Monday, scores of N.I.H. employees signed their names to a letter saying those actions had been undertaken on the basis of ideological preferences and without scientific staff input, effectively censoring research on issues like health disparities, Covid, the health effects of climate change and sexual health.

Dr. Bhattacharya said on Tuesday that he had set up a process for scientists to appeal funding cuts. The agency, he said, would vet appeals within weeks.

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Salton Sea is emitting foul-smelling hydrogen sulfide gas, triggering health concerns

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Salton Sea is emitting foul-smelling hydrogen sulfide gas, triggering health concerns

On scorching days when winds blow across the California desert, the Salton Sea regularly gives off a stench of decay resembling rotten eggs.

New research has found that the shrinking lake is emitting the foul-smelling gas hydrogen sulfide more frequently and at higher levels than previously measured.

The findings document how the odors from the Salton Sea add to the air quality problems and health concerns in communities near the lake, where windblown dust drifts from exposed stretches of lakebed and where people suffer from high rates of asthma and other respiratory illnesses.

“The communities around the Salton Sea are on the front lines of a worsening environmental health crisis,” said Mara Freilich, a co-author of the study and assistant professor in Brown University’s Department of Earth, Environmental and Planetary Sciences.

The Salton Sea is California’s largest lake, covering more than 300 square miles in Imperial and Riverside counties. Hydrogen sulfide is released as a byproduct of decaying algae and other organic material in the lake, where accumulating fertilizers and other nutrients from agricultural runoff and wastewater feed the growth of algae.

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Hydrogen sulfide, or H2S, is toxic and studies have found that health effects of exposure at certain levels can include dizziness, headaches, vomiting, cough, chest tightness and depression. Although being exposed to high levels in the workplace is a widely known health hazard, less is known about the health effects of chronic exposure to the gas at lower levels.

People who live near the Salton Sea, many of them farmworkers, have complained for years that the stench, which tends to emerge most strongly in August and September, can give them headaches, nausea and nosebleeds.

Freilich and other researchers analyzed existing air-quality data from three monitoring stations maintained by the South Coast Air Quality Management District in Indio, Mecca and the reservation of the Torres Martinez Desert Cahuilla Indians.

They worked with the local nonprofit group Alianza Coachella Valley to install an additional air-quality sensor on a wooden piling protruding from shallow water near the north shore. The sensor has often detected hydrogen sulfide at high levels.

Examining data from different monitoring sites between May 1 and July 25, 2024, they found a striking contrast. Although the monitor on the Torres Martinez reservation detected hydrogen sulfide at levels exceeding the state air-quality standard for only four hours during that time, the sensor over the water found 177 hours with levels above the threshold.

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The scientists said their results indicate that a significant portion of the gas that’s being released by the Salton Sea isn’t being measured, even as the stench drifts through the area’s predominantly Latino communities.

“These findings highlight the need for improved air quality monitoring and more effective environmental management policies to protect public health in the region,” the researchers wrote in the study, which was published May 31 in the journal GeoHealth.

The Salton Sea lies about 242 feet below sea level in the Salton Trough, which over thousands of years has cycled between filling with Colorado River water and drying out. The lake was formed most recently in 1905-07, when the Colorado flooded the region, filling the low-lying basin.

In the 1950s and ‘60s, the Salton Sea became a popular destination where tourists flocked to go fishing, boating and waterskiing. Celebrities including Frank Sinatra and Lucille Ball visited the lake during its heyday.

But lakeside communities deteriorated after flooding in the 1970s. Fishing waned as the lake grew too salty for introduced species such as corvina, and people stopped boating as the water quality worsened.

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The lake has for more than a century been sustained by water draining off farms in the Imperial Valley, but it has been shrinking since the early 2000s, when the Imperial Irrigation District began selling a portion of its Colorado River water to growing urban areas under an agreement with agencies in San Diego County and the Coachella Valley.

The lake’s level has declined about 13 feet since 2003. Its water is now about twice as salty as the ocean and continues to get saltier with evaporation. Bird populations have declined.

Hydrogen sulfide builds up in the lower, oxygen-deprived layer of water in the lake as decaying algae and other material decompose. During the hottest times of year, a warm upper layer of water forms. Then, when winds churn up the lake, some of the deeper water can rise to the surface and release the stinky gas into the air.

California’s ambient air-quality standard is 30 parts per billion, averaged over one hour. The study found that under certain wind conditions, hydrogen sulfide levels were on average 17 parts per billion higher at the newly installed sensor over the water compared with an existing monitor near the shore.

Sometimes, the sensor detected levels as high as about 200 parts per billion.

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People can detect the smell of the gas, however, at levels as low as 1 or 2 parts per billion.

“Residents exposed to hydrogen sulfide are impacted not only in their physical health — experiencing respiratory irritation, headaches and fatigue — but as well in their quality of life,” said Diego Centeno, the study’s lead author, who conducted the research while studying at Brown University and is now a doctoral student at UCLA.

“If you want to be active outside, go on a run or do something, and it smells like rotten eggs, you’d be more inclined not to,” Centeno said. “Especially during summertime, nobody wants to go outside.”

Centeno grew up within sight of the Salton Sea in the low-income community of North Shore. He said he was always fascinated by the immense body of water, not knowing why he never saw anyone bathing or boating in it.

“As water levels continue to decline, if nothing is done, this hydrogen sulfide gas really has the potential to grow,” Centeno said. “So the more we understand, the more we can learn how to mitigate and restore the Salton Sea.”

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The researchers said their findings highlight the need for increased air-quality monitoring around the Salton Sea, and for regulators to focus on hydrogen sulfide as a pollutant that affects people’s health.

Freilich said regional water regulators should prioritize setting of water-quality standards for the Salton Sea, a step that could lead to efforts to treat or reduce the nutrient levels of water flowing into the lake.

“The water quality in the sea is affecting the air quality,” she said. “It requires the attention of multiple agencies, because it is something that connects water quality and air quality, which are typically handled separately.”

The South Coast Air Quality Management District, or AQMD, regulates air pollution in the Coachella Valley, including the northern portion of the Salton Sea. In May, the agency installed a fourth monitor for hydrogen sulfide on the northeastern side of the lake.

“This H2S monitoring network is very comprehensive,” said Rainbow Yeung, an AQMD spokesperson, adding that there are currently only a few other monitors reporting such data in the country.

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Yeung said in an email that the sensor installed by the researchers is of a different type than the agency’s monitors and “may have higher H2S readings as the location of the sensor is over the source of likely emissions, which can be dispersed and therefore may not be representative of levels experienced by the community.”

AQMD issues alerts whenever hydrogen sulfide levels reach the state standard of 33 ppb at any of the monitoring sites. (Residents can sign up to receive these air-quality alerts at www.saltonseaodor.org.)

The California Office of Environmental Health Hazard Assessment has established a chronic exposure threshold for hydrogen sulfide of 8 parts per billion, a level at which long-term exposure over many years may begin to result in health effects.

The highest annual average concentration at any of the AQMD monitoring sites since 2016 has been 5.5 parts per billion, and annual averages have typically been less than 3 parts per billion, levels at which health effects are not expected, Yeung said.

The water that drains from Imperial Valley farmland and feeds the sea comes from the Colorado River. A quarter-century of mostly dry years compounded by climate change has prompted difficult negotiations among seven states over how to use less water from the dwindling river.

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As these talks examine water-saving solutions, Freilich said, policymakers should “account for the health impacts on communities” and prioritize steps that will help mitigate the problems.

California officials recently sent water flowing from a pipe onto hundreds of acres of dry lake bed near the south shore, filling a complex of shallow ponds in an effort to create wetland habitat for fish and birds, and help control lung-damaging dust.

It’s not known how these new wetlands might affect emissions of hydrogen sulfide, and Freilich said she and her team plan additional studies focusing on wetlands and shallow-water areas.

Consuelo Márquez, a Coachella resident who has helped with the research, said she lived for several years as a child in North Shore, where she got nosebleeds and experienced the rotten egg odor, a “really strong fishy smell.”

“I would wake up with blood on my pillow,” she said. When she asked her father about it, she recalled him saying: “This happens because of the lake, because of the air.”

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She said the study’s results validate the concerns many people have been raising for years.

Aydee Palomino, a co-author of the study and environmental justice project manager for the group Alianza Coachella Valley, said the study shows people are “breathing in pollutants that are under the radar of traditional monitoring systems.”

“This has the potential to have really far-reaching ramifications if it’s not addressed,” Palomino said.

Funding for the research came from the Burroughs Wellcome Fund, Google’s Environmental Justice Data Fund and NASA. But Freilich learned in March that the Trump administration had terminated the NASA grant under an order targeting diversity, equity and inclusion programs.

The researchers have an ongoing appeal of that decision, which Freilich said has been disruptive to ongoing work.

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“The community is who’s going to suffer at the end of the day,” Palomino said. “And it is unfortunate because now it comes back to us to fill in the research gaps.”

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