Fourteen people have died from an outbreak of hepatitis A in San Diego, and experts believe it to be the deadliest outbreak of the disease in the US in decades, the Guardian has learned. In large part, the victims were homeless people who have had to contend with a lack of 24-hour public restrooms, even though hand-washing is one of the best defenses against infection.

The number of cases has exceeded other large outbreaks, said a Centers for Disease Control (CDC) spokesperson, and is “likely the most deaths in an outbreak in the US in the past 20 years”, the period in which the CDC has operated its electronic reporting system. In 2003, three people died and at least 124 were hospitalized after eating contaminated salsa at a Pennsylvania restaurant. In 2013, 69 people across 10 states were hospitalized after eating contaminated pomegranate seeds.

Yet in San Diego, 264 people have been hospitalized, roughly 70% of them homeless, in an outbreak that began last November, according to local health officials. Nine of the 14 deaths have occurred since mid-July. The virus, which impairs liver function, causing jaundice, fatigue, joint pain and, in the most serious cases, death, is largely spread through food or water contaminated by fecal matter. Hepatitis A has a long incubation period – up to 28 days – which means people can spread the disease before they’re aware they’re infected.(theguardian)…[+]

Pope Francis will travel to Myanmar and Bangladesh this year for a landmark visit that is likely to focus international attention on the plight of the stateless Rohingya Muslim minority. The leader of the world’s 1.2 billion Catholics will be in Myanmar from 27 to 30 November and neighbouring Bangladesh from 30 November to 2 December, the Vatican said on Monday. The visit to Myanmar will be the first by any pope to the country formerly known as Burma. Pope John Paul II visited Bangladesh in 1986. Francis has regularly spoken out in defence of the Rohingya, a persecuted Muslim group in predominantly Buddhist Myanmar. On Sunday he bemoaned the latest “sad reports of the persecution of a religious minority, our Rohingya brothers” adding: “I would like to express my closeness to them and all of us ask the Lord to save them and to prompt men and women of good faith to help them and ensure their full rights.”(theguardian)…[+]

A nurse jailed for life for killing two patients with lethal drug overdoses murdered at least 90 patients in total, police said. Niels Hoegel, 40, was jailed in February 2015 for two murders and several attempted murders of intensive-care patients at Delmenhorst hospital near the northern city of Bremen. Police said on Monday that investigators exhuming and analysing more bodies had since found evidence of many more murders.

“The death toll is unique in the history of the German republic,” said the chief police investigator, Arne Schmidt, adding that Hoegel killed randomly and preyed especially on those in critical condition. “[There was] evidence for at least 90 murders, and at least as many [suspected] cases again that can no longer be proven,” he told a press conference, declaring himself “speechless” at the outcome. Hoegel admitted to injecting patients with a drug that can cause heart failure or circulatory collapse so he could then try to revive them and, when successful, shine as a saviour before his medical peers. He said he felt euphoric when he managed to bring a patient back to life, and devastated when he failed.(theguardian)…[+]