City officials in San Diego have declared a public health emergency over an outbreak of hepatitis A that has been linked to at least 15 deaths and 400 hospitalizations.

The liver disease outbreak started last November, with the homeless population affected most. The emergency declaration made on Friday will help the city access state funds and provide legal protection for new sanitation measures, The Union-Tribune reported.

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Areas with high concentrations of homeless people will receive roughly 40 portable hand-washing stations to help combat the disease. It can spread through fecal matter when people fail to thoroughly clean their hands after using the restroom.

Crews also plan to use bleach-spiked water for high-pressure washing to remove “all feces, blood, bodily fluids or contaminated surfaces,” according to a sanitation plan outlined in a letter Thursday.

Other cities in the region can expect to see similar hand-washing and street-sanitizing efforts, said Dr. Wilma Wooten, the region’s public health officer.

After previous vaccination and educational programs failed to significantly reduce the infection rate, and with death reports spiking in recent weeks, San Diego decided to mimic a campaign used in Los Angeles, which is home to tens of thousands of homeless, in an attempt to curb the outbreak.

“We know that L.A. has had no local cases of hepatitis A related to the strain that we’re seeing here in San Diego,” Wooten said. “If they’re doing it there and they haven’t had any cases, it could be beneficial here as well.”

Related: Liver Cancer Is Tough to Diagnose: Here’s Why

The moves in San Diego follow finger-pointing between city and county officials, with both sides insisting they were doing the best they could under tough circumstances, the newspaper said.

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“There is no precedent for this,” Wooten said. “We will definitely have a playbook for if we have something like this in the future. But this is the first time we have had something of this nature happen.”

This Fox News piece is used by permission; the Associated Press contributed to this report.

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