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

Sixteen East Tennesseans have contracted Hepatitis A since the end of June. That's in addition to 23 people who had it in April.

The Campbell County Health Department is now vaccinating children to try to slow the growth of the community-wide outbreak of Hepatitis A.

Thursday, workers visited Campbell County's six largest day care centers to give the first round of the vaccine.They administered shots to 181 children and 51 adult daycare employees.

Young children can pick up the virus and not display any symptoms, but still pass it to others. That's why the day care centers were the first target.

"It was really scary to me because my two children had it in high school, of course that was years ago, but I knew how sick they got," Kandyland Day Care employee Edna Bolton explained Thursday. "I was real happy when they said they'd like to give shots, because I don't want to pick it up."

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Campbell County day care centers on alert for Hepatitis A

Thursday, officials will go to six licensed day cares with vaccines for workers and children age two and over.

They're targeting children because they can have the virus without knowing it and still infect others.

Since the Regional Health Department declared a community-wide Hepatitis-A outbreak in Campbell County, day care owners say they've been even more vigilant about things like hand-washing.

"It makes me more aware," Little Lamb Christian Day Care Center owner Mary Shiveley explains. "The kids are like, 'Do we have to wash our hands again?'"

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Knoxville (WVLT) - The Regional Health Department says they have "a major public health problem" on their hands.

Since Monday, six additional cases of Hepatitis-A have shown up in Campbell County.

Despite what the Health Department calls ëintense efforts to control or stop the spread of the virus,' it's now become a widespread community issue, meaning it's being spread person to person not from any single source.

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July 26, 2005
KNews
Kristi L. Nelson

With 16 cases confirmed in the past month, health officials were cited as announcing Tuesday that a "community-wide outbreak" of hepatitis A in Campbell County is requiring "intense efforts" to stop the spread.

Dr. Paul Erwin, director of the East Tennessee Regional Health Office, was cited as saying the confirmation of "several" cases in children is particularly concerning, and that officials haven't identified a source for the outbreak.

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By KRISTI L. NELSON, nelsonk@knews.com
July 26, 2005

With 16 cases confirmed in the past month, health officials announced Tuesday that a "community-wide outbreak" of hepatitis A in Campbell County is requiring "intense efforts" to stop the spread.

The confirmation of "several" cases in children is particularly concerning, said Dr. Paul Erwin, director of the East Tennessee Regional Health Office. Children often don't show symptoms when infected with hepatitis A but can still spread the virus to others. Officials haven't identified a source for the outbreak.

On Thursday the Campbell County Health Department and ETHRO will give hepatitis A vaccinations to all workers and children 2 and older in Campbell County's six day-care centers. So far, only one of the confirmed cases is in a day-care worker, Erwin said, "but daycares can be a place where hepatitis A can come in and go out (into the community) very quickly."

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Campbell County
July 26, 2005

Lafollette, Campbell County (WVLT) - A tenth case of Hepatitis-A is confirmed in Campbell County.

Health officials confirmed another case last week in a daycare worker in Jacksboro.

At this point, health officials do not believe the new case is related to the daycare.

Health officials say the person is part of the extended family involved in the previous cases. Health officials say they will re-interview all the people who have contracted the virus recently to check for a direct connection, or even indirect connections through their children.

At this point, there is no indication of the source of these recent Hepatitis-A cases.

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July 22, 2005
By CATHARYN CAMPBELL
6 News Reporter

JACKSBORO (WATE) -- A new confirmed case of Hepatitis A turned up in East Tennessee at a daycare center in Jacksboro.

The Campbell County Health Department gave more than 60 shots to kids and workers Friday at the Eagle Bluff Child Care Center.

A representative from the facility said one of her employees tested positive for the virus Thursday. The worker had been sick for about two weeks.

It's not clear right now how the worker was infected but its possible the worker spread the virus for two weeks.

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PETALING JAYA, July 24 (Bernama) -- It is estimated that 50 per cent of Malaysians under 30 years of age do not have antibodies against Hepatitis A and were therefore susceptible to the disease, Deputy Prime Minister Datuk Seri Najib Tun Razak said.

"Paradoxically, as we become more affluent and less of the population get infected at an early age, we are actually more susceptible to Hepatitis A infection as adults, as most of us do not have the antibodies to fight Hepatitis A," he said at a charity dinner organised by the Malaysian Liver Foundation here Saturday.

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Daycare worker tests positive for Hepatitis A

Campbell Co. residents infected with Hepatitis A looking for answers

Investigation continues into latest Hepatitis A outbreak

New Hepatitis A outbreak reported in Campbell, Scott counties

July 22, 2005

By CATHARYN CAMPBELL
6 News Reporter

LaFOLLETTE (WATE) -- A call-in program on LaFollette radio station Q105 was the meeting place Friday for some of the people in Campbell County infected with Hepatitis A. They wanted to put their heads together to see if they can figure out why the virus has been a problem in their community.

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When diners become ill and blame something they ate, state experts start sleuthing. They interview the victims, conduct food lineups and try to narrow down the suspects.
By Scott Joseph
Sentinel Restaurant Critic
July 20, 2005

Sometimes people think it's just a touch of the flu, a 24-hour bug. Upset stomach, cramps and diarrhea might be some of the discomforts they experience. But on occasion, these are actually indicators of a food-borne illness, and, for epidemiologists such as Dean Bodager, they aren't symptoms, they're clues.

Whenever there is an outbreak of food-borne illnesses, it falls to Bodager and other members of the Florida Department of Health to track down the source. Sometimes it's simple. Most outbreaks occur at the point of preparation -- a restaurant employee who didn't wash his or her hands properly, food that wasn't kept at the correct temperature to prevent bacteria growth, or some sort of cross-contamination.

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July 20, 2005
KnoxNews

Health officials reported Monday that investigations have found no new or pending cases of hepatitis A in Campbell or Scott counties.

A "cluster" of eight confirmed cases reported since June 23 - seven in Campbell County, one in Scott - were "primarily in two extended families," said Sandy Halford of East Tennessee Regional Health Office's communicable disease control. That "lessens the likelihood that there has been any public exposure" to hepatitis A, she added.

Halford also said health officials have not found evidence that a restaurant is involved. "I know that's something the people of Campbell County worry about," she said.

Hepatitis A is spread by poor hygiene or contact with an infected person.

ETRHO is still looking at whether these latest cases might be linked with an outbreak of 23 hepatitis A cases in April in Campbell, Anderson and Scott counties. The source of that outbreak was never confirmed.

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July 19, 2005

East Tennessee health officials are still trying to determine the cause of eight more cases of Hepatitis A in the area.

The new cases follow an outbreak ofthe disease in April.

Seven of the cases are in Campbell County and one is in Scott County. All ofthe new cases were reported before the end of June.

Investigators are now interviewing infected people to see if they can find any connections that would reveal the source of the outbreak.

Health officials are also trying to determine whether the newer cases are related in any way to the April outbreak.

Katie Allison Granju , Online Producer

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July 18, 2005
By CATHARYN CAMPBELL
6 News Reporter

JACKSBORO (WATE) -- An investigation continues into the recent outbreak of Hepatitis A in Campbell and Scott counties. The eight people infected filled out a questionnaire to help health officials find the source of the virus.

So far, the source is a mystery.

No new cases have been reported since Friday.

Case workers at the Tennessee Regional Health Department are entering the information into a database. They're looking for a link to grocery stores, restaurants, daycare centers, or even social gatherings where Hepatitis A is easily spread.

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July 16, 2005
Knox News
Associated Press

A "cluster" of eight confirmed cases of hepatitis A in Campbell and Scott counties may be a lingering effect from a larger outbreak nearly three months ago, health officials said Friday.

"We are aggressively investigating and interviewing each of these cases, just as we did when we had the small outbreak in April, looking for a common source," said Sandy Halford, spokeswoman for the East Tennessee Regional Health Department.

But health officials noted that several weeks after the April outbreak of 23 cases in Campbell, Anderson and Scott counties, some second-generation infections occurred. They now wonder if the latest illnesses may be a third generation.

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FOR IMMEDIATE RELEASE
Contact Bill Marler
206-794-5043 or bmarler@marlerclark.com

SEATTLE (July 15, 2005) -- Two East Tennessee counties, Campbell and Scott, have reported an increased incidence of hepatitis A cases for the second time this year. The East Tennessee Regional Health Department has confirmed eight cases of hepatitis A since June 25, and the Health Department is working to determine the source of a potential outbreak. In April, 2005, 23 cases were confirmed in Campbell, Scott, and Anderson counties, but health officials were unable to pinpoint the source of the earlier outbreak.

Hepatitis A is a virus that primarily infects the liver. Symptoms of infection may not appear for 15-50 days after exposure to the virus. They include muscle aches, headache, loss of appetite, abdominal discomfort, fever, and malaise. After a few days of initial symptoms, jaundice (yellowing of the skin and eyes) sets in. In rare cases, the hepatitis A virus causes liver failure and impairs the infected person's cognitive functioning.

"Ideally, outbreaks would be prevented by vaccination against hepatitis A," said William Marler, a Seattle attorney with a law practice dedicated to representing victims of foodborne illness. "I've represented hundreds of people in the last two years who either became ill with, or were exposed to, the hepatitis A virus. Some have had liver transplants, or even died after suffering from acute hepatitis A infection." The CDC estimates that at least 100 people die each year after suffering from hepatitis A-induced liver failure.

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A woman who asked 6 News not to use her name said she was one of the confirmed Hepatitis A cases in Campbell County.
July 15, 2005

KNOXVILLE (WATE) -- Health authorities in two East Tennessee counties are reporting eight confirmed cases of Hepatitis A.

Seven of the case are in Campbell County, with one in Scott County.

The Regional Health Department told 6 News five of the cases were just confirmed this week. The first was discovered June 25.

So far, no common source linking these cases has been found. It is possible the recent cases are linked to the Hepatitis A outbreak 6 News was first to report in April.

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July 15, 2005

Regional Health Department, Knoxville (WVLT) - Just about three months after an outbreak of the Hepatitis-A virus in Campbell County, many folks now are wondering if it's spreading again.

Eight new cases since June 23rd have health officials taking a serious look at the situation.

Volunteer TV's Kim Bedford has the latest on the cases.

Volunteer TV News spoke with the East Tennessee Regional Health Department earlier, and officials there tell us seven Campbell County residents and one Scott County resident have contracted the Hepatitis-A virus since June 23rd.

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Wednesday, July 13, 2005
By Brad Wible
Los Angeles Times

The rate of hepatitis A infections in the United States has shrunk by 76 percent since the beginning of a vaccination program in 1999 targeting children in 17 high-risk states, federal researchers reported today.

The program has driven the rate of infection down to 2.6 cases per 100,000 people, or 7,653 cases, in 2003, the latest year for which figures are available. That is the lowest rate since monitoring of the disease began in the 1960s, according to the report published in the Journal of the American Medical Association.

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By ELISE COMTOIS, Sun Staff

It's only July, and hepatitis A cases in New Hampshire are already double the normal number.

Hepatitis A is a liver disease that can cause a person to be ill for months. There have been 48 cases of the virus reported this year, much higher than the normal 15 or 20 per year.

While the hardest hit area seems to be Merrimack County, with a total of 21
hepatitis A cases, southern New Hampshire hasn't escaped the outbreak.

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By J.M. Hirsch, Associated Press Writer | July 7, 2005

CONCORD, N.H. --A spike in hepatitis A infections has become an outbreak after efforts to vaccinate at-risk populations earlier this year failed to control the spread of the virus, state health officials said Thursday.

So far this year the state has confirmed 48 cases, more than half of which officials attributed to drug abuse or contact with those who abuse drugs. New Hampshire typically sees just 15 to 20 cases a year.

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William D. Marler (www.williammarler.com), an attorney at Marler Clark LLP PS (http://www.marlerclark.com) has extensive experience representing victims of bacterial and viral food poisonings. Since 1993, Marler Clark has represented victims of most of the largest foodborne illness outbreaks in the United States, including the 1993 Jack in the Box E. coli, 1998 Odwalla E. coli, 1999 Sun Orchard Salmonella, 2002 ConAgra E. coli and Chili's Salmonella outbreaks, the 2003 Chi Chi's Hepatitis A outbreak, and the 2004 Sheetz Salmonella outbreak.
Bill feels that a lawyer should do more than just sue corporations. That is why he speaks frequently on issues of safe food and formed Outbreak, Inc. (http://www.outbreakinc.com), a not-for-profit business dedicated to explaining to companies why it is in their interest to avoid food illness litigation. Bill also has created (http://marlerblog.com) as a way of updating the Web on issues of interest to him.

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July 6, 2005

Associated Press

Concord, N.H. -- The New Hampshire Department of Health and Human Services was cited as saying that the state has seen a dramatic increase in cases of Hepatitis A, with 48 confirmed cases so far this year, up from a usual 15 to 20 cases per year.

The story notes that Health and Human Services Commissioner John Stephen on Thursday is expected to discuss measures the state has taken to deal with the increase and what people can do to avoid the illness.

In May, state officials said drug abuse was helping fuel the increase and urged that drug users be vaccinated.

Last year, the state set up clinics and vaccinated about 2,500 people after they were possibly exposed to hepatitis A at a Taco Bell restaurant in Derry.

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From the CDC

SIGNS & SYMPTOMS

Adults will have signs and symptoms more often than children.
jaundice
fatigue
abdominal pain
loss of appetite
nausea
diarrhea
fever

CAUSE

Hepatitis A virus (HAV)

LONG-TERM EFFECTS

There is no chronic (long-term) infection.
Once you have had hepatitis A you cannot get it again.
About 15% of people infected with HAV will have prolonged or relapsing symptoms over a 6-9 month period.

TRANSMISSION

HAV is found in the stool (feces) of persons with hepatitis A.
HAV is usually spread from person to person by putting something in the mouth (even though it may look clean) that has been contaminated with the stool of a person with hepatitis A.

PERSONS AT RISK OF INFECTION

Household contacts of infected persons
Sex contacts of infected persons
Persons, especially children, living in areas with increased rates of hepatitis A during the baseline period from 1987-1997. (view map)
Persons traveling to countries where hepatitis A is common (view map)
Men who have sex with men
Injecting and non-injecting drug users

PREVENTION

Hepatitis A vaccine is the best protection.
Short-term protection against hepatitis A is available from immune globulin. It can be given before and within 2 weeks after coming in contact with HAV.
Always wash your hands with soap and water after using the bathroom, changing a diaper, and before preparing and eating food.

VACCINE RECOMMENDATIONS

Vaccine is recommended for the following persons 2 years of age and older:
Travelers to areas with increased rates of hepatitis A (view map)
Men who have sex with men
Injecting and non-injecting drug users
Persons with clotting-factor disorders (e.g. hemophilia)
Persons with chronic liver disease
Children living in areas with increased rates of hepatitis A during the baseline period from 1987-1997. (view map)

TRENDS & STATISTICS

Occurs in epidemics both nationwide and in communities
During epidemic years, the number of reported cases reached 35,000.
In the late 1990s, hepatitis A vaccine was more widely used and the number of cases reached historic lows.
One-third of Americans have evidence of past infection (immunity).

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From FDA - Bad Bug Book

Hepatitis A virus (HAV) is classified with the enterovirus group of the Picornaviridae family. HAV has a single molecule of RNA surrounded by a small (27 nm diameter) protein capsid and a buoyant density in CsCl of 1.33 g/ml. Many other picornaviruses cause human disease, including polioviruses, coxsackieviruses, echoviruses, and rhinoviruses (cold viruses).

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By Carole Sugarman

My daughter never met a chicken tender she didn't like. But during a recent family vacation in Florida, 9-year-old Anna was struck with a bad case of salmonellosis -- disease caused by salmonella. And while we'll never know for sure, we strongly suspect it was caused by contaminated, undercooked poultry at one of her daily restaurant chicken meals.

There is more than a little irony in this tale of excruciating stomach pains, bathroom vigils and hospital emergency rooms.

As a food writer for 25 years, I've interviewed numerous victims of food-borne diseases and parents of children who've died from them. I've attended scores of conferences and hearings where food safety issues are debated among government officials, industry and activist groups.

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POSTED: 11:58 am EDT July 5, 2005

CONCORD, N.H. -- New Hampshire health officials said Tuesday that the state has seen a dramatic increase in cases of hepatitis A -- a virus that causes liver disease.

The Department of Health and Human Services said that in a typical year, New Hampshire sees between 15 and 20 cases. So far this year, there have been 48 confirmed cases.

At a press conference on Thursday, Health and Human Services Commissioner John Stephen is expected to discuss measures the state has taken to deal with the increase and what people can do to avoid the illness.

In May, state officials said drug abuse was helping fuel the increase and urged that drug users be vaccinated.

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Hepatitis A is a communicable (or contagious) disease that spreads from person to person. It is transmitted by the "fecal -- oral route." This does not mean, or course, that Hepatitis A transmission requires that fecal material from an infectious individual must come in contact directly with the mouth of a susceptible individual. It is almost always true that the virus infects a susceptible individual when he or she ingests it, but it gets to the mouth by an indirect route.

Food contaminated with the virus is the most common vehicle transmitting Hepatitis A. The food preparer or cook is the individual most often contaminating the food. He or she is generally not ill: the peak time of infectivity (i.e., when the most virus is present in the stool of an infectious individual) is during the 2 weeks before illness begins. Hepatitis A is spread almost exclusively through fecal-oral contact, generally from person-to-person, or via contaminated food or water. Outbreaks associated with food have been increasingly implicated as a significant source of Hepatitis A infection. Such "outbreaks are usually associated with contamination of food during preparation by an HAV-infected food handler."2 Indeed, "[v]iral gastroenteritis was reported as the most common food-borne illness in Minnesota from 1984 to 1991, predominantly associated with poor personal hygiene of infected food handlers."3

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www.about-hepatitis.com

Hepatitis A is one of five human hepatitis viruses that primarily infect the human liver and cause human illness. (There are many other viruses that can inflame the liver which infect us more generally.) The other known human hepatitis viruses are hepatitis B, C, D, and E. Hepatitis A is relatively unusual in nations with developed sanitation systems such as the United States. Nevertheless, it continues to occur here.

Each year, an estimated 100 persons die as a result of acute liver failure in the United States due to Hepatitis A1. Approximately 30 - 50,000 cases occur yearly in the United States and the direct and indirect costs of these cases exceed $300 million1. The unfortunate aspect of these statistics is that with 21st century medicine, Hepatitis A is totally preventable, and isolated cases, and especially outbreaks relegated to food consumption, need not occur.

Viral Hepatitis is a major public health concern in the United States, and a source of si1gnificant morbidity and mortality.1 The Hepatitis A virus or "HAV" is heat stable and will survive for up to a month at ambient temperatures in the environment.

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