A major outbreak of Heptatitis A in San Diego that has resulted in 15 deaths and 400 hospitalizations has sent authorities into emergency mode, declaring a general wellbeing crisis on Friday. The liver illness first began cropping up back in November, and the disease appears to be affecting the destitute population the most at the moment.

The city will now dip into state finances to provide legal protection to pave the way for enacting new sanitation measures. They will focus on adding 40 portable hand-washing stations in areas with high concentrations of homeless people to stop the spread of the disease, which is likely spreading through fecal matter that results from people not washing their hands thoroughly enough after using the restroom.

Work crews will also conduct high pressure washing with water mixed with bleach to remove all surfaces contaminated by bodily fluids.

“Eight people have now died as a result of the hepatitis A outbreak in San Diego the County Health and Human Services Agency announced today,” reads a statement from the county of San Diego. “All eight people had underlying medical conditions at the time of their death. There have been 275 cases identified during the local outbreak, including 194 people who have been hospitalized. People who are either homeless or using illicit drugs account for at least seven in ten of the illnesses, and just over one in five also have hepatitis C.”