The death toll from a hepatitis outbreak in San Diego has risen to 15 people, and work crews have taken to using power washers to clean a “fecally contaminated environment.” The outbreak of hepatitis A has primarily affected the homeless population, where lack of hand-washing and poor cleanliness has led to the spread of the disease.

A total of 300 more people have been hospitalized, leading authorities to jump into action. The street power washing will take place in downtown San Diego on Monday and will continue every other week.

In addition, San Diego County has installed 40 hand-washing stations at areas where homeless people congregate, and are planning on adding more stations later on.

“We continue to stress that people who are at risk should get vaccinated and people need to be vigilant about washing their hands after going to the bathroom,” said Wilma Wooten, M.D., M.P.H., County public health officer. “We are continuing to evaluate cases, but so far public health investigators have not identified any common food, drink or drug source as the contributing cause to this outbreak.”

“Today is World Hepatitis Day, and anyone in San Diego County who is concerned about getting hepatitis A is encouraged to get the vaccine if they have not already gotten it,” said Wooten.