Canterbury hepatitis A outbreak infects seven
10 January 2006
By JOANNA DAVIS
Canterbury health officials are frantically trying to find the source of a debilitating hepatitis A outbreak that has infected seven people.
Normally, only two or three cases of the viral illness, which can cause jaundice, are identified each year in Canterbury.
Poor food hygiene is the most likely cause of the outbreak which has infected seven people, some of whom are related, since Christmas.
Canterbury District Health Board medical officer of health Dr Mel Brieseman said at least two people had received hospital treatment for the illness.
One had been discharged, but he did not know about the other's condition last night.
All those affected were adults aged between 20 and 75.
GPs were on alert for early symptoms of the infection, which include feeling generally unwell, abdominal discomfort, nausea and fever, he said.
Liver illness causes jaundice in the later stages of the disease.
"We anticipate there could well be more notifications within the next few days," Brieseman said.
Overseas, hepatitis A was sometimes spread through a contaminated water supply, but that was "definitely not" a possibility in Canterbury.
"It's a bowel-to-mouth spread, usually from direct faecal contamination on foodstuffs. Usually, someone hasn't washed their hands after going to the toilet, or else sewage discharge is contaminating the food supply," Brieseman said.
Four health-protection officers were trying to find a connection among the sufferers.
AdvertisementAdvertisement"The difficulty is the incubation period is up to seven weeks," he said.
"Remembering what you ate and where seven weeks ago could be tricky."
Brieseman said it was possible all the cases could be traced to one restaurant, cafe or other food business, but no single source had been found yet.
Shutting down a cafe would be a possibility if the source was found to be a food-handling fault.
Brieseman, who has had hepatitis A, said the infection made people feel "just rotten".
"You feel crook, often for some time wondering why. After some time, your urine goes dark and your eyes turn yellow. It's easy to pick up at that point," he said.
Deaths were uncommon from the disease, he said.
Christchurch Hospital infectious diseases specialist Dr Sarah Metcalf said only "supportive" treatment could be given to hepatitis A patients in hospital.
"There's no specific treatment for it; just letting the virus take its course," she said.
Patients were given intravenous fluids if they could not eat or drink, and medication for pain relief.
In rare cases, people could become so sick their liver stopped functioning, and they could require an urgent liver transplant, she said.
"However, most people will feel unwell, have not much appetite and they may notice a yellow tinge to the whites of their eyes or their skin from being jaundiced," she said.
Metcalf expected public health officials would find a common source for the infection. She said there was a possibility there were two sources, but that would be highly coincidental.
Christchurch Hospital would normally treat about one patient a year with hepatitis A, Metcalf said.
Brieseman said the outbreak was a reminder to people to take care with hygiene.
"The Canterbury District Health Board views this outbreak as a serious public health issue and cannot stress enough the importance of hand-washing after going to the toilet and before handling food," he said.
"Workers and employers in the food industry are also reminded not to work with food when they are suffering from any form of stomach upset.
"People shouldn't need to be told these two messages, but it's a reminder just in case."
