Authorities are scrambling to get a handle on an epidemic of Hepatitis A that has struck the city of San Diego, killing 15 people and requiring the hospitalization of 400 more. The county of San Diego declared a general wellbeing crisis on Friday, and have begun taking action to get a handle on the problem as a result.

The liver illness first emerged back in November, and it appears to be disproportionately affecting the homeless population of the city. The city will add a few dozen portable hand washing stations in areas where there are a lot of homeless people. Authorities think the disease is spreading through fecal matter because people aren’t washing their hands properly after going to the bathroom.

In addition to the hand washing stations, workers will use high pressure washers using water and bleach to clean surfaces that have been contaminated.

“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.”