The death toll of a brutal outbreak of hepatitis A among the homeless community in San Diego County has risen to 15 people, and now authorities are sending crews to power-wash affected areas as well as install dozens of handwashing stations in a desperate bid to stop the spread of the disease. Hepatitis A is believed to have sprung up from a lack of hand washing and poor cleanliness, leading to more than 300 people being hospitalized.

Street power washing crews started working in downtown San Diego on Monday, and they’ll continue to do so every other week. Also, San Diego County has installed 40 hand washing stations in homeless areas, and will install more stations soon.

The county blamed a “fecally contaminated environment” for the spread of the dangerous disease. The disease can generally avoided with proper hand washing.