Hepatitis A Lawyer & Attorney : Marler Clark : Hepatitis A Blog

The Hepatitis A Blog supplements Marler Clark's Web site www.about-hepatitis.com, a site that provides information about hepatitis A, the symptoms and risks of infection, hepatitis A testing/detection, and how to prevent the spread of the hepatitis A virus.

While about-hepatitis.com is informational in purpose, the hepatitis A blog is intended to be a forum for discussion among the site's authors and users. The authors of the hepatitis A blog conduct surveillance on matters related to hepatitis A's impact on individuals and families in different cities, states, and regions.

Please join us in a conversation about hepatitis A that includes subjects such as outbreaks, recalls, and legal cases by commenting on posts that you find interesting

About hepatitis A (HAV)

Hepatitis A is the only common vaccine-preventable foodborne disease in the United States (Fiore, 2004). It is one of five human hepatitis viruses that primarily infect the human liver and cause human illness. Unlike hepatitis B and C, hepatitis A doesn’t develop into chronic hepatitis or cirrhosis, which are both potentially fatal conditions; however, infection with the hepatitis A virus (HAV) can still lead to acute liver failure and death.

Hepatitis A is much more common in countries with underdeveloped sanitation systems. This includes most of the world: an increased transmission rate is seen in all countries other than the United States, Canada, Japan, Australia, New Zealand, and the countries of Western Europe. Nevertheless, it continues to occur in the United States; approximately one-third of the population has been previously infected with HAV (Fiore, 2004; Centers for Disease Control and Prevention [CDC], 2009a). Each year, approximately 30,000 to 50,000 cases of hepatitis A occur in the United States. Although the national incidence (1.0 case per 100,000 population) of hepatitis A was the lowest ever recorded in 2007, it is estimated that 25,000 new infections occurred that year after asymptomatic infection and underreporting were taken into account.

In 2007, a total of 2,979 acute symptomatic cases of hepatitis A were reported (CDC, 2009b). Among the 1,047 cases with available information regarding foodborne or waterborne exposure, 6.5% were found to be foodborne or waterborne related, about one-third the proportion reported at the last peak in 2003. However, 2500 cases remained without known risk factors.

Estimates of the annual direct and indirect costs of hepatitis A in the United States have ranged from $300 million to $488.8 million in 1997 dollars (CDC, 2007). Nationwide, adults who become ill miss an average of 27 work days per illness and 11 to 22 percent of those infected are hospitalized (CDC, 2009c). These are avoidable illnesses, since 21st Century medicine and the advent of hepatitis A vaccine have rendered hepatitis A infections totally preventable.


How is Hepatitis A Infection Transmitted?

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The Illinois Health Department has released its investigation into this summer's hepatitis A outbreak. It concluded the source of most of cases was food eaten at the Milan McDonald's.

The first case of hepatitis A in the Quad city area was discovered last June. As we first reported back then, the first confirmed case of the liver illness was an employee at the Milan McDonald's. Over the next two months, a total of 34 confirmed hepatitis A cases were reported.

A state investigation has concluded most of the cases originated at the Milan McDonald's and most of the cases *would have been prevented* if only that one employee had properly washed hands.

The findings of the investigation by the Illinois Department of Public Health concludes "the index case was a food handler at the McDonalds in Milan, Illinois and had onset of illness June 11." Investigators also found "other possible sources in the community were ruled out."

And, "The source of the outbreak for the majority of outbreak cases was food eaten at the McDonalds, Milan, Illinois where a food handler worked while infectious and handled foods that were not later cooked."

The state investigation goes on to say that "if the first employee with hepatitis A had used proper hand-washing technique while working the transmission of hepatitis A through food would not have occurred."

And, "proper hand-washing by the index case would have prevented the majority of the cases in the community. Reporting of the index case by designated reporters before June 25 would have.. reduced the number of cases in the community."

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Washing your hands is one of the best ways to protect against this serious liver disease

Are you traveling to another country, such as Mexico, Africa, Central or South America, Asia (except Japan) or Eastern Europe? Do you have children in a daycare center, work directly with children or help ill adults? If you answered yes to any of these questions, you should consider receiving the hepatitis A vaccine.

Hepatitis A is a serious liver disease caused by the hepatitis A virus. It is the most common type of hepatitis and it can range from mild "flu-like" symptoms to sudden and severe onset liver failure. One in five people are actually hospitalized because of hepatitis A. Some common symptoms are feeling very tired, sick to your stomach, losing weight without trying, pain on the right side of the belly, under the rib cage, a fever or sore muscles. Additionally, older adults may have jaundice (yellow skin), along with dark urine and clay-colored stools.

How is hepatitis A spread? The virus is found in the stool of an infected person. It is spread when a person eats food or drinks water that has come in contact with infected stool. This can happen when an employee with hepatitis A does not wash his or her hands after using the bathroom and then prepares food. The same is true in a daycare center when workers do not wash their hands after changing a diaper.

Another way of contracting hepatitis A is by eating raw oysters or undercooked clams. Similarly, if you travel to a country where hepatitis A is common and you eat uncooked foods or drink tap water, you may contract the virus.

GET VACCINATED

A simple way you can protect yourself from hepatitis A is to get the vaccine. This involves a series of two shots and they are usually 100 percent effective when you get them both before you are exposed to the virus.

A vaccine, like any medicine, could possibly cause serious problems, such as a severe allergic reaction. However, the risk of hepatitis A vaccine causing serious harm, or death, is extremely small and getting a shot is much safer than getting the disease.

Some mild problems include soreness where the shot was given, headache, loss of appetite, and tiredness. Severe problems, which are very rare, would be an allergic reaction that would occur within a few minutes to a few hours of the shot. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heartbeat or dizziness.

There are certain people in the community who should be routinely vaccinated with the hepatitis A vaccine. First, all children age 1, and anyone age 1 and older traveling to or working in countries with high or intermediate prevalence of hepatitis A. Some of these countries are listed at the beginning of this article, but you should consult your physician for more information.

Next, all children and adolescents 18 years of age who live in states or communities where routine vaccination has been implemented because of high disease incidences should receive the vaccine. Lastly, persons who fall within the following groups should also receive the vaccine: men who have sex with men, addicts who use street drugs, people who are treated with clotting factor concentrates and those with chronic liver disease.

There are also certain members of the population who should not receive the vaccine. First, anyone who has ever had a severe (life-threatening) allergic reaction to a previous dose of hepatitis A vaccine should not get another dose. Anyone who has a severe (life threatening) allergy to any vaccine components should not get the vaccine. Next, anyone who is moderately or severely ill at the time the shot is scheduled should probably wait until they recover. Lastly, the safety of the hepatitis A vaccine for pregnant woman has not been determined. Nevertheless, there is no evidence that it is harmful to either pregnant women or their unborn babies and the risk, if any, is thought to be very low.

It is important to note that you can only get the hepatitis A virus once and it does not lead to long-term liver problems. After it is contracted, your body builds up a defense against it. It can, as previously explained, be prevented totally if certain precautions are taken and the vaccine is received. If you meet the criteria listed above, please contact your healthcare provider to learn more.

This column is provided by the Richmond County Medical Society. Dr. Scafuri is a member of the Society, and specializes in infectious disease. He maintains a practice in West Brighton.

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According to the Quad-City Times, Trinity Regional Health System has paid $80,000 to Rock Island County to help reimburse unanticipated expenses related to this past summer's hepatitis A outbreak.

Trinity Medical Center treated some of at least 32 patients who came down with the liver disease in July and August. The Rock Island County Health Department inoculated more than 5,324 area residents against the disease during vaccination clinics held in late July.

An investigation completed in early August by the Rock Island County Sheriff's Department concluded that Trinity Regional Health System and Metropolitan Medical Laboratory did not report cases of hepatitis A as promptly as required by law to the county health department, where the belated reports were not acted upon immediately because an employee was on vacation.

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Iowa experienced a 294 percent increase in Hepatitis A cases over the previous three-year period, the state Department of Public Health reports.

According to the annual Iowa Surveillance of Notifiable and Other Diseases report, the Cornhusker State went from a low of 13 Hepatitis A cases statewide in 2006 to 109 cases in 2008.

The uptick represents a 294 percent increase over 2005-2007, the previous three year average. A cluster of cases in southeast Iowa in 2008 was blamed on a restaurant server who continued to work while infected with the liver disease.

According to the Centers for Disease Control and Prevention (CDC), Hepatitis A is usually spread when the virus is taken in by mouth from contact with objects, food, or drinks contaminated by the feces (or stool) of an infected persons.

"The best way to prevent the spread of hepatitis A is to practice good hand washing at all times," said Deb Steffen, community health manager at Floyd Valley Hospital in LeMars, IA.

Steffen’s Plymouth County got through 2008 without a single Hepatitis A case. Nationally, the number of Hepatitis A cases is running at its lowest level in 40 years. A vaccine became widely available after 1995, and it has cut down on incidents of the diseases.
 

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Quad Cities residents are not going to soon forget the Hepatitis A outbreak at the Milan McDonald’s.

An Alpha, IL couple, Nichole and John Shannon, became the latest to sue McDonald’s and Milan, IL franchise owner Kevin Murphy in Rock Island County Circuit Court late last week. Mrs. Shannon was hospitalized from July 11-17, tested positive for the Hepatitis A virus, and suffered from liver damage, according the lawsuit.

The Milan McDonald’s was closed July15-17 on orders from the Rock Island County Health Department. The department took the action when a second McDonald’s employee was diagnosed with Hepatitis A on July 15.

At least 32 people testing positive for Hepatitis A are now associated in the Milan McDonald’s outbreak.   Counties in both western Illinois and eastern Iowa have contributed to the count. Eighteen of those cases are from Rock Island County where the fast food burger joint is located.

In addition to the injured, 5,324 people who made the mistake of dining at the establishment took advantage of the health department’s offer for free vaccines, which can prevent sickness from occurring after exposure. 

Those exposed to the virus and got shots are part of a class action lawsuit that has also been filed.

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Swan's Island is a 30-minute ride on the Captain Henry Lee, a 17-car ferry out of Bass Harbor, Maine. When you arrive after Labor Day, there are only about 350 people on the 7,000 acre island.

Now one has died and at least five others are ill --all from Hepatitis A.   The six victims and four other suspected cases all stayed in the same Swan's Island house, although apparently not all at the same time. 

The fatality was a woman over age 50 who died after returning home.   Other victims range in age from 13 to 69.  One person remains in the hospital.

During the summer, visitors to Swan's Island increases the population to as many as 1,000.  The Hepatitis A outbreak claimed victims from the Midwest and Middle Atlantic States who were apparently summer visitors.

The Maine Centers for Disease Control and Prevention's Dr. Dora Anne Mills says the source of the Hepatitis A is unclear.  The house involved did have a septic system problem and nearby clam flats were closed down as a precaution.

Hepatitis A is spread through unsanitary conditions through saliva or fecal contamination.  It is not common in Maine as the state averages only about 11 cases each year.  No longer residents are involved in the current outbreak.  Swan's Island is on the coast near Bar Harbor.

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Outside of the Milan, IL McDonald's, the one place where you really should not be unless you have a Hepatitis A vaccine is Imperial Beach, CA.

That's because northbound ocean currents funnel the polluted water from the Tijuana River into the Imperial Beach surf.  To say that the Mexican waters are polluted is to put it mildly.   In addition to the usual sewage and garbage debris there are all the elements of Mexico's lively drug trade, including all those used needles and broken vials. 

A 2007 survey by the nonprofit environmental group Wildcoast found that 60 percent of regular ocean users at Imperial Beach suffered from illnesses caused by water contamination.

In part of because of that study and past volunteer efforts, public health workers were on the beach Saturday offering free Hepatitis A vaccines to surfers and swimmers alike.  San Diego State University studies have shown Hepatitis A is present in 80 percent of water samples taken from the beach.

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