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Hepatitis Blog

Surveillance & Analysis on Hepatitis News & Outbreaks

Hepatitis A Linked to Costco

The Public Health Agency of Canada is collaborating with federal and provincial public health partners to investigate an outbreak of Hepatitis A infections in three provinces linked to the frozen fruit product: Nature’s Touch Organic Berry Cherry Blend. The Canadian Food Inspection Agency (CFIA) has issued a food recall warning advising Canadians of the recall of the frozen fruit product that has been distributed in Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador.

The Public Health Agency of Canada advises Canadians not to consume the frozen fruit product Nature’s Touch Organic Berry Cherry Blend sold exclusively at Costco warehouse locations in Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador.

The overall risk to Canadians is low. Hepatitis A is a disease that can cause inflammation of the liver. Hepatitis A can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. You can get the Hepatitis A virus by eating contaminated food or water or through contact with an infected person’s stool. Adequate vaccination can protect against the Hepatitis A virus.

Currently, there are 12 cases of Hepatitis A in three provinces related to this outbreak: Ontario (9), Quebec (2), and Newfoundland and Labrador (1). Individuals became sick in February and March of this year. Some of the individuals who became ill have reported eating the recalled product. The majority of cases (58%) are male, with an average age of 37 years. Three cases have been hospitalized.

Sandy Cinema Patrons Urged to get Hepatitis A Treatment

Clackamas County Public Health officials are investigating an incident of potential exposure to Hepatitis A at a Sandy movie theater.

People who attended the Sandy Cinema, at 16605 Champion Way in Sandy, and ate or drank from the concession stand during certain days and hours earlier this month may have been exposed.

The specific days and hours in question are:

  • Feb. 12: 11 a.m. to closing
  • Feb. 13: 6 p.m. to closing
  • Feb. 14: 2 p.m. to closing
  • Feb. 15: 1:30 p.m. to closing

Clackamas County Public Health is advising people who may have been exposed to check their immunization status, and if they have not been immunized against Hepatitis A, to obtain medication that can decrease their chances of becoming ill. These are effective for up to two weeks after exposure.

The medication should not be given if more than two weeks have passed.

  • Those individuals aged 1 to 40, who have not previously received the Hepatitis A vaccine, are recommended to get a single dose of the vaccine. Twinrix (which is a combination Hepatitis A and B vaccine) is not appropriate for this purpose.
  • For those individuals less than 12 months old or over 40, vaccine is not approved. They are recommended to receive immune globulin shots.

Clackamas County Public Health also has established a call-in line to provide information. The call-in number is 503-742-5320. The call center will be active through 7 p.m. tonight and from 9 a.m. to 4 p.m. Saturday.

Clackamas County is updating inventories in the region to assure there is adequate supply. For questions about where to find vaccine please contact the call center.

Medications will also be made available Tuesday, Wednesday and Thursday, Feb. 23 through Feb. 25 at Legacy Medical Group Firwood, 36860 Industrial Way, Sandy, from 6:30 to 9 p.m.

The Hepatitis A case was first reported to Clackamas County Public Health late on February 17.

Public Health officials said theater owners have been fully cooperative and stressed that the risk to the public is extremely low and there is no continued risk to the public.

“This recommendation for treatment doesn’t apply to people who ate at Sandy Cinema on other days,” said Dr. Sarah Present, Clackamas County Public Health Officer. ”We know the likelihood of infection is low but we are recommending vaccinations for exposed persons because the risk is not zero and there are effective medications that can further decrease the risk of illness.”

Hepatitis A is a viral disease of the liver that is contagious. It is spread from person to person, often by inadequate handwashing after using the toilet or changing diapers, or eating food prepared by an infected person.

Typical symptoms include fatigue, fever, and loss of appetite, abdominal pain, nausea, vomiting, or jaundice (a yellowing of the skin or eyes). Some infections may be mild but it can develop into severe liver disease. Symptoms usually develop 3-4 weeks after exposure but it may be up to 50 days.

For more information, go to the Clackamas County Public Health Division web page at: www.clackamas.us/publichealth/

Seneca County Health Department Reports Hepatitis A Ill Employee at Mark’s Pizzeria

The Seneca County Health Department has confirmed a case of Hepatitis A in a food service worker. The food service worker is employed at the Marks Pizzeria located at 1963 Kingdom Plaza, Waterloo, NY 13165. Public health officials state that individuals not previously vaccinated for Hepatitis A and who consumed cold foods, such as subs, salads, vegetables, lemons and celery sticks from Mark’s Pizzeria should seek treatment.

Anyone previously immunized for Hepatitis A by their physician or through clinics recently held by the Seneca County Health Department DO NOT need to be re-immunized.

Individuals who consumed cold foods from the Mark’s Pizzeria located at 1963 Kingdom Plaza, Waterloo, NY 13165 on November 13, 2015 through Wednesday, November 18, 2015 are advised to monitor themselves for signs and symptoms of Hepatitis A for the next 4-6 weeks.

If you consumed cold foods from Mark’s Pizzeria located at 1963 Kingdom Plaza, Waterloo, NY 13165 on Thursday, November 19, 2015 through Saturday, November 28, 2015, you should seek treatment for Hepatitis A.  Clinics will be held in the Seneca County Office Building located at 1 DiPronio Drive Waterloo, NY 3rd Floor Board of Supervisor’s Room on Thursday, December 3, 2015- 1:00 pm-7:00 pm, Monday, December 7, 2015 – 3:00 pm-7:00 pm and Thursday, December 10, 2015- 12:00 pm-4:00 pm.

Individuals are strongly encouraged to preregister and arrive during their scheduled appointment times.

To pre-register visit www.co.seneca.ny.us or for more information call the New York State Department of Health Hotline at 1-844-364-6397.

Waterloo New York McDonalds Hepatitis A Worry

The Seneca County Health Department has confirmed a case of Hepatitis A in a food service worker employed at the McDonalds located at 2500 Mound Rd. Waterloo, NY. Public health officials are stressing there is a low risk of contracting illness, however, individuals who have not been previously vaccinated for Hepatitis A and who consumed food/drink from McDonalds on the following dates should consider treatment.

If you ate at McDonald’s at 2500 Mound Rd. Waterloo, NY on 10/31 you should attend the 11/14/15 clinic.

If you ate at McDonald’s at 2500 Mound Road Waterloo, NY on any of the following dates you should attend either the 11/14 or the 11/15 clinic.

Monday, November 2nd, 2015

Tuesday, November 3rd, 2015

Thursday, November, 5th 2015

Friday, November 6th 2015

Sunday, November 8th 2015

Clinics will be held offering Hepatitis A Vaccine

Saturday, November 14, 2015- 1:00 pm-8:00 pm

Sunday, November 15, 2015 – 10:00 am-4:00 pm

Mynderse Academy Gymnasium

105 Troy Street

Seneca Falls, NY 13148

To preregister for a clinic www.health.state.ny.us/gotoclinic/50

For other additional questions: New York State Department of Health Hotline: 1-844-364-6397

Waterloo/Seneca Falls Hepatitis A FAQ

What happened at the McDonalds in Waterloo?

A worker at the McDonalds on Route 414 and Mound Road in Waterloo NY, a short distance from Exit 41 off the NYS Thruway, worked while they may have been shedding Hepatitis A virus, before the worker was diagnosed with the illness. Because of how Hepatitis A is spread, this may have put customers and coworkers at that McDonalds at risk of acquiring Hepatitis A.

Did Humans Pick Up Hepatitis A From Animals?

4KWSlaRThe hepatitis A virus can trigger acute liver inflammation which generally has a mild course in small children but which can become dangerous in adults. The virus, which is found worldwide, has previously been considered to be a purely human pathogen, which at most is found in isolated cases in non-human primates. An international team of researchers under the direction of the University of Bonn has now discovered in a large-scale study with nearly 16,000 specimens from small mammals from various continents that the hepatitis A virus – like HIV or Ebola as well – is of likely animal origin. The results currently appear in the renowned journal Proceedings of the National Academy of Sciences of the United States of America (PNAS).

An infection with the hepatitis A virus can trigger acute inflammation of the liver, which generally does not cause any symptoms in children and resolves without major complications. “In tropical regions, nearly all young children are infected with the hepatitis A virus and from that time on, they are immune to this disease,” says Prof. Dr. Jan Felix Drexler from the Institute of Virology at the University of Bonn Medical Centre and the German Centre for Infection Research (DZIF). By contrast, if adults become infected with the hepatitis A virus, the symptoms can be more serious, and the disease can even have a fatal outcome. The virus has been found to date only in humans and a few non-human primates. Its origins were mysterious.

Virologists from the University of Bonn Hospital, together with their colleagues from several German and international research institutes worldwide, searched for viruses related to the hepatitis A virus. They investigated a total of 15,987 specimens from 209 different species of small mammals: from rodents to shrews and bats to hedgehogs. Viruses from these mammals are very similar to the human hepatitis A virus with regard to their genetic properties, protein structures, immune response and patterns of infection. “The seemingly purely human virus is thus most likely of animal origin,” says Drexler. “The study enables new perspectives for risk assessments of emerging viruses by investigating functional, ecologic and pathogenic patterns instead of phylogeny only”.

The scientists’ evolutionary investigations may even hint at distant ancestry of the hepatitis A virus in primordial insect viruses. “It is possible that insect viruses infected insect-eating small mammals millions of years ago and that these viruses then developed into the precursors of the hepatitis A virus,” says the virologist from the University of Bonn Medical Centre.

The researcher assumes that small mammals were important hosts for the preservation and evolution of the viruses. “Otherwise the hepatitis A virus would actually have gone extinct long ago in small human populations due to the lifelong immunity of the persons once infected with it,” Drexler reasons. “However, patients need not fear that they could contract a hepatitis A virus infection through bats or hedgehogs. It has likely been a very long time since humans first contracted the hepatitis A precursor virus from animals – moreover, such incidents are very rare,” says the virologist from the University of Bonn Medical Centre.

Latest on South Carolina Hardee’s Hepatitis A Scare

Hepatitis-4As of September 25th, the South Carolina Department of Health and Environmental Control announced it has provided 4,809 vaccinations through its hepatitis A vaccine clinics in Spartanburg and Greenville.

Vaccinations are being offered to individuals who might have been exposed to hepatitis A at two Hardee’s restaurants located in Spartanburg County. The restaurants are located at 12209 Greenville Highway in Lyman and 1397 E. Main St. in Duncan.

To serve customers and staff, DHEC will operate a clinic at the Spartanburg County Health Department on Saturday, September 26th from 9 a.m. to noon. Clinic operations will continue on Monday, September 28th.

Customers and staff who, as of September 25th, ate at the Lyman-area restaurant September 11th through September 15th, or the Duncan-area restaurant September 11th through September 13th, should receive post-exposure treatment for hepatitis A. Post-exposure treatment is recommended for individuals if it can be administered less than two weeks from their date of consuming anything from the restaurants.

Customers and staff who ate at the restaurants between August 31st and September 10th are not likely to benefit from post-exposure treatment. Anyone who ate at these Hardee’s restaurants between these dates should watch for symptoms of infection, such as nausea, vomiting, and jaundice, which is yellowing of the eyes and skin. Seek medical care if symptoms develop.

Hepatitis A Risk at Hardee’s in South Carolina

Customers who ate at two Hardee’s restaurants in Spartanburg County might have been exposed to the hepatitis A virus, the S.C. Department of Health and Environmental Control announced today. One location is at 12209 Greenville Highway in Lyman and involves the dates between Aug. 31 and Sept. 15, 2015. The second location is at 1397 E. Main St. in Duncan and involves the dates between Sept. 1 and Sept. 13, 2015.

DHEC was notified on Sept. 17 that an employee of the Lyman-area restaurant tested positive for hepatitis A. An investigation of this case revealed hepatitis A illness in a close contact that works at the Duncan-area Hardee’s location. Customers and staff who consumed food or drink at these restaurants during these dates could have been exposed to the hepatitis A virus.

“Hepatitis A is a liver disease caused by a virus,” said Dr. Anna-Kathryn Rye, M.D. and medical consultant in DHEC’s Bureau of Disease Control. “People usually become sick within two to six weeks after being exposed to the virus, so it’s important to get treatment as soon as possible to prevent the virus from developing into hepatitis A infection.”

DHEC is working with these restaurants to identify and contact customers and staff who might have been exposed to the virus. This illness is not a foodborne outbreak.

Rye recommended that customers and staff who as of today ate at the Lyman-area restaurant between Sept. 4 and Sept. 15, 2015, or the Duncan-area restaurant between Sept. 4 and Sept. 13, 2015, should receive post-exposure treatment for hepatitis A.

Post-exposure treatment is recommended for individuals if it can be administered less than two weeks from their date of consuming anything from the restaurant with the last date being Sept. 15

Customers and staff who ate at these restaurants during these dates are encouraged to come to DHEC’s Spartanburg County Health Department or Greenville County Health Department for post-exposure treatment on Saturday, Sept. 19 or Sunday, Sept. 20 from 1 p.m. to 5 p.m. Both health departments will also offer post-exposure treatment on Monday, Sept. 21 from 8:30 a.m to 5 p.m.

The Spartanburg County Health Department is located at 151 E. Wood St. in Spartanburg. The Greenville Health Department is located at 200 University Ridge in Greenville.

The vaccine is of no proven benefit when administered more than 14 days after exposure. As of today, customers and staff who ate at these restaurants between Aug. 31 and Sept. 3 are therefore not likely to benefit from post-exposure treatment. Anyone who ate at one these Hardee’s restaurants between these dates should watch for symptoms of infection, such as nausea, vomiting, and jaundice, which would cause yellowing of the eyes and skin. Seek medical care if symptoms develop.

If you have a question or concern about possible exposure, please call DHEC at 1-800-868-0404. Operators are available Friday until 8 p.m., Saturday and Sunday between the hours of 8:00 a.m. and 6 p.m., and next Monday through Friday between 8:00 a.m. and 6 p.m.

Hepatitis A Causes Utah Restaurant Scare

The Southwest Utah Public Health Department (SWUPHD) has received confirmation that a food handler working at a restaurant in Iron County has tested positive for hepatitis A.

The health department is seeking to alert customers who ate at the Pizza Cart in Cedar City from April 29th through June 1st, as they may have been exposed to hepatitis A.

Anyone previously vaccinated for hepatitis A is protected from infection.

Unvaccinated customers who ate at the restaurant from May 19th through June 1st should be treated with a hepatitis A vaccination (and immune globulin, depending on age). Treatment is available at the SWUPHD or your healthcare provider. People who visited the restaurant outside of these dates do not need preventive treatment. Contact the health department at 435-865-5148 for more information.

Customers who ate at the restaurant from April 29th through June 1st should contact their doctor or healthcare provider if they develop symptoms of hepatitis A; including jaundice (yellowing of the eyes and skin), fatigue, loss of appetite, abdominal pain, nausea, vomiting, diarrhea, and fever.

Hepatitis A Fears in New Jersey

According to the Camden County Health Department in New Jersey, a server at the Iron Hill Brewery & Restaurant in Voorhees, NJ, recently tested positive for the Hepatitis A virus. The health department has reportedly vaccinated the rest of the employees to protect them and keep the virus from spreading.

http://www.dreamstime.com/stock-images-person-receiving-vaccine-close-up-vaccination-protection-image34491574The restaurant issued a statement saying that the health department had immediately been contacted, the person was no longer at work, and that there was little to no risk to the public health from the person’s illness.

second confirmed case in Burlington County, NJ, involves a restaurant server who went to a Marlton, NJ, hospital with flu-like symptoms consistent with Hepatitis A infection. Lab results later confirmed that diagnosis. The individual has not returned to work.

Camden County health officials have been working with health officials in Burlington County and the New Jersey Department of Health to investigate the illnesses.

Arkansas Subway in Hepatitis A Spotlight

subwayindexThe Arkansas Department of Health (ADH) is warning of a possible Hepatitis A Virus (Hep A) exposure after a Subway employee in Morrilton tested positive for the virus. The Subway is located at 1812 State Highway 9 Business, just off of Exit 108 on Interstate 40 in Morrilton.

Any individual, who has eaten food from the Morrilton Subway between March 25 and April 5 and is experiencing symptoms should contact their primary care provider immediately. Typical symptoms of Hep A include, but are not limited to: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain or jaundice (yellowing of the skin or eyes).

Hep A is a contagious liver disease that results from infection with the Hepatitis A virus. It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. A person can transmit the virus to others up to 2 weeks before and one week after symptoms appear.

There are no specific treatments once a person gets Hep A. However, it can be prevented through vaccination or through receipt of a medicine called immune globulin. This medicine contains antibodies from other people who are immune to Hep A.

People without symptoms who have eaten at this Subway between March 25 and April 5 and are:

  • under 1 year of age, are too young to be vaccinated and may wish to seek out immune globulin from a health care provider.
  • between 1 year to 40 years of age, and if never vaccinated for Hep A, may wish to seek out vaccination from a health care provider.
  • 41 years old and older, and never vaccinated for Hep A, may wish to seek out immune globulin. Vaccine is not known to be effective in this group post-exposure.

As a matter of policy, employees at Subway use disposable gloves between customers and while preparing food. These behaviors have likely reduced the risk of illness to the public. Nevertheless, individuals who have eaten at this Subway between March 25 and April 5, who are pregnant or have severe chronic illness, in particular, liver-related disease, are encouraged to consult with their doctor and consider the above treatment.

The Conway County Health Unit, located at 100 Hospital Drive in Morrilton, will have immune globulin and Hep A vaccine, which can be administered upon request with an appointment on or after Wednesday, April 15. If you wish to get one of these medicines from the health department, call (501) 354-4652 to make an appointment.

At this time, no other Hep A illnesses have been reported to ADH; however, the virus can cause illness anytime from 2-7 weeks after exposure. If infected, most people will develop symptoms 3-4 weeks after exposure.

Hep A is usually spread when a person ingests fecal matter – even in microscopic amounts – from contact with objects, food or drinks contaminated by the feces, or stool, of an infected person.

Many people, especially children, may have no symptoms. The older a person is when they get Hep A, typically the more severe symptoms they have.

Almost all people who get Hep A recover completely and do not have any lasting liver damage, although they may feel sick for months.

Hepatitis A is preventable through vaccination. Hepatitis A vaccine has been recommended for school children for many years and one dose of Hep A vaccine is required for entry into kindergarten and first grade as of 2014. Most adults are likely not vaccinated, but may have been if they received vaccinations prior to traveling internationally.