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Hepatitis Blog

Surveillance & Analysis on Hepatitis News & Outbreaks

Deadly Hepatitis A Outbreak Spreads

According to the San Diego County Health and Human Services Agency, 228 cases of hepatitis A have been reported in 2017, with 161 people hospitalized during the outbreak.  There have been 5 deaths. Public health investigators continue to evaluate cases, but most of those who have become ill are either homeless and/or illicit drug users. Hepatitis A is most commonly spread person-to-person through the fecal-oral route. The disease can be prevented by getting vaccinated. So far, officials said no common food, drink or drug source has been identified as the cause.

In addition, the number of hepatitis A cases over last year in Macomb, Oakland, Wayne and St. Clair counties has increased tenfold, spawning a Michigan Department of Health and Human Services investigation. 190 cases have been reported between August 1, 2016 and June 26, 2017, which has resulted in 10 deaths so far. Officials said it represents a significant health threat, with links to either illicit drug use, sexual activity or close contact among household members.

Symptoms of hepatitis A include jaundice, fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine and light-colored stools. Symptoms usually appear over several days and last less than two months. However, some people can be ill for as long as six months. Hepatitis A can also sometimes cause liver failure and death.

Hepatitis A Ruins a Wedding

News 12 reports that a Westchester couple says their dream wedding turned into a nightmare as a result of the hepatitis A scare at the Cortlandt Manor venue where they were recently married.

Jay and Jennifer Gorinson had their wedding and reception on June 10 at the Monteverde at Oldstone Restaurant.

The newlyweds have since had to visit the Westchester County Health Department in White Plains for hepatitis A vaccinations. The Gorinsons say they were called about the newly issued Health Department warning while on their honeymoon.

A bartender with hepatitis A worked at the venue while she was infectious, putting the Gorinsons and their 175 wedding guests at risk of contracting the virus.

The virus is transmitted through contaminated food and water, and can be treated with a vaccine. Its symptoms include fever, abdominal pain, dark urine and yellowing of the skin and eyes. It can take from two weeks to two months to develop.

In a previous response, a Monteverde spokesman says the bartender didn’t work the Gorinson wedding, but that some bridal guests did buy drinks from her. Jay Gorinson says the memories of their wedding day are ruined and that the restaurant’s owner and manager have been dodging his calls and emails for nearly a week.

He says he finally received an answer from Monteverde on Tuesday, saying only that they were “unaware” that the bartender was ill.

“It’s embarrassing and sad that the venue has taken no responsibility for this, and we hope it’s something that no one else has to encounter on their wedding day,” says Jay Gorinson.

The Gorinsons say they will have to return to the Westchester County Health Department in six months for further treatment.  In the meantime, they say they’re considering legal action.

Hepatitis A in Westchester

Dr. Sherlita Amler, Westchester County’s Health Commissioner, is encouraging people who consumed beverages at Monteverde at Oldstone, a restaurant and event space at 28 Bear Mountain Bridge Road in Cortlandt Manor, to protect themselves against Hepatitis A following confirmation that an employee with the disease worked at the restaurant while infectious.

Hepatitis A is a viral liver diseasetransmitted by ingesting contaminated food or water or through direct contact with an infectious person. “The key to prevention is a quick response,” said Westchester County Executive Robert P. Astorino.

Patrons who consumed beverages at Monteverde between May 31 and June 10 are being urged to contact the Westchester County Health Department, which will offer free Hepatitis A treatment on Thursday, June 15, from 11 a.m. to 3 p.m. at Monteverde at Oldstone and on Friday, June 16, from 9 a.m. to 3 p.m. at the Westchester County Health Department clinic at 134 Court Street in White Plains.

No appointments are needed, but individuals interested in attending a clinic are encouraged to pre-register online or call the Health Department at (914) 995-7499.

The Health Department has been contacting all individuals who dined at Monteverde between May 31 and June 10 to alert them to their potential exposure.  The treatment is a Hepatitis A vaccine or immune globulin. Anyone age 18 or younger must be accompanied by a parent. Pregnant women who may have been exposed should contact their prenatal care provider about treatment. Preventive treatment is only effective if given within two weeks of potential exposure.

Hepatitis A is generally a mild illness that affects the liver. Symptoms include fatigue, fever, poor appetite, abdominal pain, diarrhea, dark urine and yellowing of the skin and eyes, and can develop from two weeks to two months after exposure

“Anyone who believes they may have symptoms of Hepatitis A should consult with their regular physician, inform their physician of the potential exposure and notify the Westchester County Department of Health,” Dr. Amler said.

As soon as the Health Department learned where the employee worked, its staff began a comprehensive investigation, with the full cooperation of the owner and in consultation with the New York State Department of Health.

Jail House Hepatitis A Risk

hepatitisa1Oakland County Jail officials are warning inmates incarcerated there earlier this month that they may have been exposed to hepatitis A.

A male prisoner in the jail tested positive for the virus, an infection of the liver which can lead to liver failure in people with a weak immune system. It’s caused by a virus expelled in feces and most often spread person to person by contaminated hands.

The sheriff’s office is advising anyone detained in the jail between May 8-23 to contact the county health division to determine potential exposure.

Bouchard said jail officials already have sanitized the areas where the inmate was housed and begun contacting anyone who might have come in contact with him.

Hepatitis A symptoms may appear from two to six weeks after exposure and include sudden abdominal pain, fever, fatigue, diarrhea, nausea, headache, dark urine, light-colored bowel movements and vomiting.

“Hepatitis A is contagious, but can be prevented with vaccination if given within 14 days of last exposure,” said Leigh-Anne Stafford, a county health officer.

Raw Tuna Poke Recalled in Hawaii over Hepatitis A

The Hawaii State Department of Health (DOH) has been notified of imported frozen raw tuna or ahi cubes distributed by Tropic Fish Hawaii, LLC on Oahu that tested positive for hepatitis A.

The product, imported from Indonesia, was used to prepare poke sold between April 27 and May 1 by food establishments on Oahu.

The Department of Health says Tropic Fish Hawaii discovered 200 tainted 15-pound cases of frozen ahi cubes; 140 of those cases were recovered and never got sold.

The imported frozen fish was used to prepare poke or food served or sold at:

  • Times Supermarket and Shima’s
    • Aiea
    • Kailua
    • Kaneohe
    • Kunia
    • Liliha
    • Mililani
    • Waipahu
    • Waimanalo
  • GP Hawaiian Food Catering
  • Crab Shack Kapolei (also known as Maile Sunset Bar & Grill in Kapolei)

2 Dead in San Diego due to Hepatitis A

Forty-two hepatitis A cases have been reported in the San Diego region since November 2016, more than four times the monthly average typically reported, the County Health and Human Services Agency announced today.

Thirty-six people were hospitalized and two died from the disease.  Twenty-three cases are men, and the cases range in age from 26 to 72 years, with an average age of 42 years.  Twenty-nine cases have a history of substance abuse, and 27 are homeless.  Five people became ill with hepatitis A after traveling outside the United States.  No common sources of infection have been identified, and investigations are still continuing.

“The County is working closely with the local health community to increase outreach to vulnerable populations to raise awareness and promote hepatitis A vaccination,” said Wilma Wooten, M.D., M.P.H., County public health officer.  “Those at risk are urged to talk to their health care providers and get vaccinated for hepatitis A.”

Hepatitis A is a vaccine-preventable disease. While the hepatitis A vaccine is recommended as part of the routine childhood vaccination schedule, most adults have not been vaccinated and may be susceptible to the hepatitis A virus.

Two doses of hepatitis A vaccine are recommended for:

  • All children (first dose of vaccine between 12 months and 23 months of age, and the second dose six to 18 months later)
  • Travelers to countries that have higher rates of hepatitis A (high-risk areas include parts of Africa and Asia, and moderate risk areas include Central and South America, Eastern Europe, and parts of Asia)
  • Men who have sex with men
  • Users of injection and non-injection illegal drugs
  • Homeless people who are living outdoors
  • Household or sexual contacts of hepatitis A patients
  • People with chronic liver diseases, such as cirrhosis, hepatitis B or hepatitis C
  • Family members or caregivers of a recent adoptee from countries where hepatitis A is common
  • People who are treated with clotting-factor concentrates

Symptoms of hepatitis A include jaundice (yellowing of the skin and eyes), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, and light-colored stools.  Symptoms usually appear over a number of days and last less than two months.  However, some people can be ill for as long as six months. Hepatitis A can sometimes cause liver failure and death.

Hepatitis A Frozen Berries in EU

At least 71 people in Europe have been sickened with Hepatitis A in an outbreak believed to be linked to frozen berries served in smoothies, according to the latest report from Eurosurveillance. That’s an increase of 15 cases since Food Safety News first reportedon the outbreak April 17.

There are at least 35 people sickened in Denmark, and another 36 sickened between Finland, Norway and Sweden. Swedish authorities say the country is experiencing ten times the normal number of Hepatitis A cases so far this year.

Most case patients reported consuming berries or smoothies around the time of exposure, but investigators have not identified a specific brand or berry origin.

This is the first foodborne Hepatitis A outbreak of nordic origin, Eurosurveillance said.

Due to Hepatitis A’s incubation range of 15 to 50 days, and the delay involved in reporting the disease, authorities expect more illnesses to surface in the coming weeks.

Cup & Saucer Cafes tied to Hepatitis A concern

cup-and-saucer-cafeJim Ryan of the Oregonian reported tonight that Multnomah County health officials are investigating two hepatitis A cases among workers at a pair of Portland Cup & Saucer Cafes.

The first of the cases was reported to the county health department on March 20, and the other was reported Monday, said county spokeswoman Julie Sullivan-Springhetti. Officials advise people who patronized the cafes on specific dates in late March to contact their health care provider “because of possible transmission at the restaurant,” she said.

Sullivan-Springhetti said people who ate or drank at the cafe at 8237 North Denver St. from March 22 to March 29 should get in touch with their health care provider to see whether they need to get a vaccination or get other preventative care. People who did the same at the 3566 Southeast Hawthorne Blvd. cafe on March 22 or March 25 should also contact their health care provider, she said.

And anyone who ate or drank at the North Portland cafe between Feb. 22 and March 21 should ask their health care provider whether they have hepatitis A symptoms, Sullivan-Springhetti said in a news release.

“We consider the risk to be relatively low,” Dr. Jennifer Vines, Multnomah County deputy health officer, said in a statement. “But there are vaccines that can lower the risk of illness if given within two weeks of possible exposure.”

Hepatitis A Grows in Michigan

Public health officials and the Michigan Department of Health and Human Services (MDHHS) are continuing to see an elevated number of hepatitis A cases in the city of Detroit, and counties of Macomb, Oakland, and Wayne.

“Together with our local health partners, we are increasing outreach to vulnerable populations to raise awareness and promote vaccination of hepatitis A,” said Dr. Eden Wells, chief medical executive of MDHHS. “Those who live, work, or play in the city of Detroit, as well as Macomb, Oakland, and Wayne counties are urged to get vaccinated for hepatitis A and talk to their healthcare provider about their risks.”

From August 1, 2016 to March 21, 2017, 107 cases of lab-confirmed hepatitis A have been reported to public health authorities in these jurisdictions. This represents an eightfold increase during the same time last year. Ages of the cases range from 22 to 86 years, with an average age of 45 years. The majority of the cases have been male. Eighty-five percent of the cases have been hospitalized with two deaths reported.  Approximately one-third of the cases have a history of substance abuse, and 16 percent of all cases are co-infected with hepatitis C. No common sources of infection have been identified.

Hepatitis A is a vaccine-preventable disease. While the hepatitis A vaccine is recommended as part of the routine childhood vaccination schedule, most adults have not been vaccinated and may be susceptible to the hepatitis A virus.

Hepatitis A vaccination is recommended for:

  • All children at age 1 year
  • Close personal contacts (e.g., household, sexual) of hepatitis A patients
  • Users of injection and non-injection illegal drugs
  • Men who have sex with men
  • People with chronic (lifelong) liver diseases, such as hepatitis B or hepatitis C. Persons with chronic liver disease have an elevated risk of death from liver failure
  • People who are treated with clotting-factor concentrates
  • Travelers to countries that have high rates of hepatitis A
  • Family members or caregivers of a recent adoptee from countries where hepatitis A is common

Individuals with hepatitis A are infectious for 2 weeks prior to symptom onset. Symptoms of hepatitis A include jaundice (yellowing of the skin), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, and light-colored stools. Symptoms usually appear over a number of days and last less than 2 months; however, some people can be ill for as long as 6 months. Hepatitis A can sometimes cause liver failure and death.

Risk factors for a hepatitis A infection include living with someone who has hepatitis A, having sexual contact with someone who has hepatitis A, or sharing injection or non-injection illegal drugs with someone who has hepatitis A. The hepatitis A virus can also be transmitted through contaminated food or water.

MDHHS encourages residents in the city of Detroit and Macomb, Oakland, and Wayne counties to check their hepatitis A vaccination status and talk to their healthcare provider about their risks for hepatitis A.

Hepatitis A case prompts public health alert in Clearwater area

A clinical case of Hepatitis A has been identified in a food handler at the Dairy Queen establishment in Clearwater located at 318 Eden Rd.

While Hepatitis A is uncommon in Interior Health, it is believed there is a low but definite risk to persons who ate food at this restaurant during the period this food handler was infectious.

To date, there have been no additional reported cases and Interior Health is taking immediate steps to ensure the safety of all staff and customers. Persons who consumed any foods or beverages from this Dairy Queen location during the following dates and times may have been exposed to Hepatitis A.

  Thursday, Dec. 8
  Friday, Dec. 9
  Saturday, Dec. 10
  Sunday, Dec. 11
  Thursday, Dec. 15
  Friday, Dec. 16
  Saturday, Dec. 17
  Sunday, Dec. 18

4 p.m. – 9 p.m. 4 p.m. – 9 p.m. 11 a.m. – 4 p.m. 4 p.m. – 9 p.m. 11 a.m. – 4 p.m. 4 p.m. – 9 p.m. 11 a.m. – 4 p.m. 11 a.m. – 4 p.m.

Hepatitis A is a disease that affects the liver and is caused by the Hepatitis A virus. The virus is found in the bowel movements (stool) of infected people. It can be spread through close personal contact or through contaminated food that has been handled by an infected person. The virus can get under nails and, despite thorough hand washing, can still contaminate food.

Symptoms usually develop 15 to 50 days after exposure and include nausea, abdominal cramps, fever, dark urine, and/or yellowing of the skin and eyes (jaundice). Illness can be more severe in adults over 50 years of age or those with chronic liver disease. Illness can last for several weeks and people generally recover completely. If you have symptoms, stay home from school and/or work. Frequent hand washing, especially after using the toilet and before handling food, remains the most effective way to avoid the spread of Hepatitis A infections.

Hepatitis A vaccine can prevent Hepatitis disease, but only if given within 14 days of exposure.

“We are advising anyone who may have been exposed to take the precaution of getting immunized,” said Dr. Sue Pollock, Medical Health Officer, Interior Health. “Hepatitis A is a serious infection and immunization is a proven and safe means of preventing illness.”

Interior Health will be providing vaccination clinics in Clearwater and Kamloops on the following dates. Please bring your immunization records with you to the clinic, if possible.

Dr. Helmcken Memorial Hospital in Clearwater:

  Friday, Dec. 23, 1-3 p.m.
  Saturday, Dec. 24 9 a.m. – noon
  Monday, Dec. 26, 11 a.m. – 2 p.m.
  Tuesday, Dec. 27, 11 a.m. – 2 p.m.

The Public Health Unit in Kamloops, 519 Columbia St.:

  Friday, Dec. 23, 1-3 p.m.
  Saturday, Dec. 24, 9 a.m. – 12:20 p.m.

Outside these clinic dates and until Wednesday Dec. 28, individuals may obtain vaccine at the Dr. Helmcken Memorial Hospital emergency department in Clearwater or at the Royal Inland Hospital emergency department in Kamloops. After Dec. 28, please contact your local public health unit to access vaccine. Individuals living outside of Clearwater and Kamloops should also contact their local public health unit for information on where to access vaccine in their region. If your exposure was more than 14 days ago, then vaccine will not be effective. Watch for signs and symptoms of Hepatitis A and, if these signs/symptoms occur, please see your family physician for testing.

If you have had Hepatitis A infection in the past or have had two doses of Hepatitis A vaccine, then you are not at risk of infection.