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

About a dozen states comply with the Centers for Disease Control (CDC) recommendations for vaccines for school-aged children.   The states have the power to enforce vaccine requirements at the school house door.

Since about 180,000 people become sick with Hepatitis A each year, and since that includes about 60,000 children, CDC recommends Hepatitis A vaccines for children entering Kindergarten for the 2009-10 school year. 

Here is the vaccine schedule as being enforced in Texas:

• Hepatitis A vaccine — Students entering Kindergarten must have two doses.
• Measles, mumps, rubella vaccine — Students entering Kindergarten must have two doses. Students in grades 1-12 must continue to meet the state requirements, which is two doses of a measles-containing vaccine and one dose each of mumps and rubella vaccine.
• Vericella vaccine — Students entering kindergarten and seventh grade must have had two doses. Students in grades 1-6 and 8-12 must continue to meet the state requirements.
• Tetanus, diphtheria, acellular peryussis-containing vaccine — Students entering seventh grade must have one dose of Tdap vaccine. Students in seventh grade must have had a booster dose of Tdap, but only if it has been five years since their last dose of a tetanus vaccine. Students in grades 8-12 must have had a booster dose of Tdap if it has been 10 years since their last dose.
•  Meningococcal vaccine — Students entering seventh grade must have one dose.

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 Did you ever notice the people in the produce department at the grocery store are always the friendliest?  That's probably no comfort to customers at the Albertson's in Littleton, CO who are being told that if they consumed store produced produce they should think about getting Hepatitis A vaccine shots.

The local health department will be offer vaccinations at Columbine United Church at 6375 South Platte Canyon Road Monday from 4 to 9 p.m. and Tuesday from 9 a.m. to 6 p.m.

The church is at South Platte Canyon Road and West Coal Mine Avenue, about one-half mile south of the Albertsons.

Health officials are warning those who have bought green onions, celery that has had the leaves trimmed, any lettuce that was not pre-bagged, any pre-cut watermelon, cantaloupe or honeydew melon.  They said the overall risk was low as the employee who tested positive for Hepatitis A did practice both thorough hand-washing and wore gloves.  

However, about 3,000 food items were subject to exposure.  For more, check out the story in Denver's last remaining daily newspaper here.

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Boy, talk about another reason to get your Hepatitis A vaccine! The Veterans Administration (VA) has acknowledged that 16 patients exposed to contaminated equipment at its medical facilities have tested positive for viral infections, including hepatitis.

According to CBS News:

VA spokeswoman Katie Roberts said Friday that 10 colonoscopy patients from the VA medical center in Murfreesboro, Tenn., tested positive for hepatitis. She said six patients from a VA clinic in Augusta, Ga., tested positive for unspecified viral infections.

The number of reported infections could rise. Roberts says the department doesn't yet have results from most of more than 10,000 veterans warned to get blood tests because they could have been exposed to contamination. Patients at a medical center in Miami also were urged to get tested.

All three sites failed to properly sterilize equipment between treatments.

 

The VA Medical Center in Murfreesboro is named for World War I hero Alvin C. York, who was a native of Pall Mall, Tenn.  For more about this distributing report, check here.

 

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 We cannot say we were really worried about this one.   Regular tourism between the People's Republic of China (PRC) and Taiwan has been underway since last July.  Apparently worry-warts have been concerned that the mainland tourists might spread Hepatitis A to residents of the island nation.

With Taiwan and China getting along, we'd hate to see anything come between them.  After all, once enough of those pink-shirted mainland tourists come visiting the island, could anything other than lasting peace be far behind?  

So, this is good news.  The Taiwan News is reporting today that Chinese tourists’ arrivals won’t cause hepatitis A epidemic according to its Centers for Disease Control.  According The News:

 

"Hepatitis A infection is highly related to environmental hygiene,... Taiwan's basic public health conditions have been largely improved compared to 20 years ago. It is unlikely that (the disease) will break out here," said Lin Ting, CDC deputy director-general.

Lin said that even if Chinese tourists with hepatitis A come to Taiwan and spread the virus, there would be only a few individual cases, not an epidemic.

But he noted that most young Taiwanese people under age 30 do not have the antibody to hepatitis A. If these people make frequent visits to Southeast Asia and mainland China and stay there for a long period of time, they must be careful about eating local food and environmental hygiene, to prevent from getting hepatitis A.

Getting a vaccination is the most efficient way to avoid contracting the infectious disease, Lin said, encouraging people to be vaccinated.

For more, go here.

 

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 Health professionals in Maine are on the lookout this week for more cases of Hepatitis A.  After a sixth school child was diagnosed with Hepatitis A it brought the total number of cases in the Kennebunk/Kennebunkport area to 12.

Officials now think that someone who traveled overseas to an area where Hepatitis A is common brought the disease back to Maine and that is what caused others to get it. The Maine-based news service, seacoastonline says:

Last week, district officials, school physician and local pediatrician Don Burgess and the Maine Center for Disease Control's Andy Pelletier met with parents to try to address their concerns. While nearly 80 percent of the school's students have received the hepatitis A vaccine, Pelletier expressed concern that 20 percent had not. Those students are vulnerable to the infection, he said.

According to the U.S. Centers for Disease Control, hepatitis A is "an acute liver disease caused by the hepatitis A virus (HAV), lasting from a few weeks to several months. It does not lead to chronic infection." It is transmitted through the ingestion of fecal matter and from close person-to-person contact or ingestion of contaminated food or drinks.

For more, go here.

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 After a fourth and now a fifth case of Hepatitis A turned up in the Kennebunkport Consolidated Schools, upset parents say they were not informed soon enough by school officials.

According to Maine news site, seacoastonline. com:

Following news that a fifth child has been diagnosed with hepatitis A, parents questioned the MSAD 71 School Board on Monday as to why all parents weren't notified after the initial outbreak at Consolidated School.

"We don't care who it is, but we want to know that it is (real)," said mother Amy Johnson.

The first two cases were diagnosed in September, according to the Maine Center for Disease Control, and both children were members of the same family. At that time, only students in those two classes were notified of the outbreak.

Three more cases were diagnosed at Consolidated between late October and early November. Six additional cases have been diagnosed in the Kennebunk/Kennebunkport area, all involving family members of the first two children.

The school district did send out a letter to all parents last week about the outbreak.  For more, go here.

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The Maine Center for Disease Control yesterday ordered 170 students vaccinated for Hepatitis A.

The shots were provided to those enrolled at the Kennebunkport Consolidated School after three children at the school were diagnosed with the virus in recent weeks.

Best known for the nearby compound of former President George H.W. Bush (see picture), the Kennebunkport area has seen nine cases of Hepatitis A.  Eight involved a single family and the ninth case was linked to that family through the school.

Dr. Dora Anne Mills, director of the Maine CDC, told Seacoastonline that officials suspect that an adult who recently traveled to a country where hepatitis A is prevalent might have brought the virus back to Kennebunkport.

A letter is being sent out to parents today.  For details, go here.

 

 

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Usually at this time of year, students are Syracuse University are only asked to put on their orange. This year, however, students and others who work in the food service are being asked to take a dose of hepatitis A vaccine after one server was diagnosed with the disease.

The food service worker presented symptoms on Friday, said Kevin Morrow, speaking for the university in an e-mail Tuesday. Lab tests were ordered and came back positive for hepatitis A, he said.

According to the Syracuse Post Standard:

The health department interviewed the infected person Friday, and learned that the individual had worked in the Shaw and Haven dining halls on Aug. 23 and 27.

The health department found that the worker was infected outside of Onondaga County, Morrow said.

Most infections from hepatitis A result from contact with a household member or sex partner, according to an e-mail sent to students Tuesday by Dr. James R. Jacobs, director of SU health services.

When a food service worker is diagnosed with the disease, the state recommends that colleagues who worked the same shift be vaccinated as a precaution, Morrow said.

Food safety advocate and attorney, Bill Marler, has long advocate that all food service workers be vaccinated.   For more on Hep A at SU, go here.

 

 

 

 

 

 

 

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After a part-time employee with Hepatitis A sent hundreds to free vaccination clinics at the county health department,  Whitey's Bar and Billiards in Burlington, Iowa will be under new ownership after Aug. 16.

On Friday, the Burlington Hawk Eye reported a happy end to the story:

Business at Whitey's has taken a hit over the last two weeks after a part-time employee was diagnosed with hepatitis A July 11. The Iowa Department of Public Health issued a warning to patrons who consumed select items at the restaurant, sending hundreds of people to free vaccination clinics at the county health department last week.

After telling some people the business would close its doors permanently Wednesday, Walker decided there were other options to explore.

On Thursday afternoon, Walker and wife Angela posted the business for sale on the Whitey's Myspace page. Within an hour, an interested party contacted the couple, requesting they remove the offer from the Web site and begin preparing a lease, Walker said.

Walker said the new owner will maintain the same kind of business.

For more on Whitey's go here.

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In the aftermath of the flooding throughout much of the Midwest, health officials are advising those involved in the cleanup to get some shots, but not others.  

Iowa's Henderson and Des Moines counties continue giving out tetanus shots -- also available at doctors' offices -- to people who have had close contact with the floodwaters. Tetanus shots are a concern for people near the floodwaters who have open wounds or the potential for injury.

"Typically, you don't get things like Hepatitis A, because it's so dilute," Des Moines County Public Health Nurse Abby West said. "Hepatitis A is not something they're recommending vaccines for."

For more about cleanup dangers, go here.

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In land that was once the independent country/state of Franklin, also known as Eastern Tennessee, the mystery continues. The Northeast Tennessee Regional Health District has not found the source of the Hepatitis A outbreak.

The location is known, near beautiful Cherokee Lake and Mooresburg in Hawkins, County, TN. At least eight people in those parts contracted Hep A, and 1,500 took advantage of the District's offer to provide free vaccines.

Sure is beautiful though.

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Cherokee Lake in Hawkins County, Tennessee is apparently Ground Zero for the Hepatitis A outbreak we reported on in the previous post.   The neighboring  Kentucky River District Health Department says there have been eight confirmed cases of hepatitis A from people who live in or have recently visited the Tennessee lake.

The health department is offering hepatitis A vaccines to anyone who has been to the lake since May 14th.  “If you get vaccinated it can prevent this virus from happening even after exposure. It’s a very serious virus and it needs to be treated,” Kentucky River District Health Department’s Renee Neace said.

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Traveling as we do, we often have time to learn about local history and why some places are different.  Take eastern Tennessee for example.   A remote territory of North Carolina before we broke with King George III, eastern Tennessee found it a.) wasn't wanted by North Carolina due to it having too many restless Native Americans, and b.) it's attempt to birth a new, independent state of Franklin wasn't welcomed by the new USA either.

It was while the State of Franklin was attempting to birth itself that North Carolina founded Hawkins County in 1787.  While Franklin was aborted after about four years of pretending to be a state, Hawkins County made the transition to Tennessee when it was admitted to the Union in 1796.

Today, Hawkins County is continuing this East Tennessee independence in offering the public
free Hepatitis A shots.    Here's what the Bristol Herald Courier is reporting:

The Northeast Regional Health Office has confirmed seven reported Hepatitis A cases in the Mooresburg community of Hawkins County. 

Free Hepatitis A vaccines will be offered to all Mooresburg Community residents Wednesday and Thursday, May 28th and 29th at the Slate Hill Baptist Church. The Slate Hill Baptist Church is located two miles off of State Highway 11 W on Slate Hill Road. The clinic will run from noon to 7p.m..

The Hawkins County Health Department is working with the Northeast Regional Health Office to give the vaccines to all adults and children (over 12 months of age). Officials are asking parents to bring immunization records for all minor children.

While we would like to know more about food outlets that might connect the seven cases, we sure like the idea of opening up the offer of free shots to everyone in the community.   Do you suppose local restaurants are taking advantage of this offer to get their staffs vaccinated?  Go for it Eastern Tennessee.   Get shot like its 1787!

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Denver is the hometown of Chipotle Mexican Grill.   So,  we are not surprised with the "homer" coverage the fast food chain is getting from Joyselle Davis, a business writer at the Rocky Mountain News.

Within the same news cycle that Terry Wesley sued Chipotle for giving him Hepatitis A from eating at the Mexican fast food chain's outlet on Fletcher Parkway in Le Mesa,  Ms. Davis writes a glowing story entitled "Chipotle rides onto a bigger stage."  In it she makes no mention of the fact that Chipolte's Kent, Ohio outlet has spread norovirus to more than 400 while the Le Mesa, CA Chipolte is serving up Hepatitus A to 21 confirmed cases so far.

Instead,  "The Rocky" has a just "slap your leg" with laughs story about how the European riders on the new "Slipstream-Chipotle" cycling team call burritos "bread."   Wow, is that funny or what?

The serious part of the story, the part that could have just as well been written by the burrito peddlers public relations department, was this:

For co-sponsor Chipotle Mexican Grill, which prides itself on using only hormone- and antibiotic-free meat, the marketing deal gives the restaurant chain a vehicle to take its additive-free ethos to the world stage.

"This is a team that's very vigorous about their drug testing and keeping their bodies clean, and that's very much our philosophy," said Jim Adams, Chipotle's executive marketing director.

Excuse us for being picky, but we are far more concerned about a restaurant chain being "pathogen free" than we are about its ethos or its cycling team.   Chipotle is making people sick.  Its customers would also like to be "drug free," but they all have to get well before that's going to happen.

Writing about Hepatitis A, the viral infection that attacks the liver and is spread by fecal contamination of water or food, isn't as much fun as those colorful new bike uniforms "The Rocky" is so excited about.  Symptoms include nausea, diarrhea, fever, fatigue, dark urine and jaundice.

But that's path Terry Wesley has been forced to take by Chipolte.  Its a far  tougher ride.  Its the one "The Rocky" apparently does not want to hear, see, or talk about.

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You are looking at the inside of a typical Chipotle Mexican Grill.   It's a very clean-looking environment.   It's always a function of local management if the interior is really kept clean and the service running smoothly.   To be honest, we don't dine at Chipotles because we don't like standing in lines period, and these places are usually so popular that there lines are long.

Well, if you assume that the Health Department has actually tested all employees (not likely) and that the food (as in many earlier Hepatitis A outbreaks) was not contaminated, then is it possible that customers who were in those lines at the La Mesa, CA Chipotle restaurant came into contact with someone or someones who were carriers of Hepatitis A as the disease has spread to at least 18 other people?  We at Hepatitis Blog have not found such an outbreak in our research.  So, anyone who dined there between March 1 and April 22 are being told by health officials to seek a medical checkup.

Hepatitis A is commonly transmitted when an object contaminated with the stool of someone with hepatitis A comes in contact with another person’s mouth. Exposure also can occur when an individual consumes food or water contaminated with the Hepatitis A virus, according to the health department.  Symptoms of hepatitis A include fever, fatigue, nausea and jaundice.

Chipotle is also dealing with a norovirus outbreak at one of its Ohio restaurants.

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Chipotle Mexican Grill is experiencing its second outbreak of the week, this one at La Mesa, CA involving Hepatitis A.   Fox 6 News reports:

The San Diego Health and Human Services Agency and County Department of Environmental Health are investigating six cases of Hepatitis A linked to a La Mesa Chipotle restaurant.

The county is recommending individuals who dined at the restaurant between March and April 22, 2008, and may see symptoms of Hepatitis A, to see their physicians for screenings.

Hepatitis A is a vaccine-preventable illness, according to health officers, and the public is urged to talk to their physicians about getting vaccinated

The other Chipotle outbreak has made more than 400 people sick in Kent, Ohio.  Go here for more on the Southern California outbreak.

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Hepatitis A is one of five human hepatitis viruses (hepatitis A, B, C, D, and E) that primarily infect the liver and cause illness. An estimated 80,000 cases occur each year in the U.S., although much higher estimates have been proposed based on mathematical modeling of the past incidence of infection. Each year, an estimated 100 persons die as a result of acute liver failure in the U.S. due to hepatitis A, but the rate of infection has dramatically decreased since the hepatitis A vaccine was licensed and became available in the U.S. in 1995.

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Contamination of food by an infected food worker is the most common mode of transmission of hepatitis A in food borne disease outbreaks (Guzewich 1999). A review of food-borne Hepatitis A outbreaks in the United States found that in many cases the infected food handler either did not seek medical care or delayed getting medical care (Fiore 2004).

So says Dr. Rajiv Bhatia, Director, Occupational and Environmental Health of the San Francisco Department of Public Health.  That's just a taste of a long article by Dr. Bhatia on the California Progress Report, in which he makes the case that paid sick days are the key to cutting down on food borne illnesses like hepatitis A.

Two years ago, San Francisco began the first city in America to require all employers to provide for paid sick days.  Now the California Assembly is considering imposing the same requirement statewide.

Dr. Bhatia says paid sick days pay positive dividends in the following areas: Avoiding transmission of infectious disease in communities;  Preventing food borne illness;Reducing expensive hospital care; Providing essential care for family members and dependents;and Addressing health disparities.  He says:

For occupations such as health care workers, child care providers, and food service workers, it is critical to keep sick workers out of the workplace.

See Dr. Bhatia's entire article here.

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We spend a lot of time observing how various state, regional and local health districts handle the challenge of an outbreak, or the potential for one.  

We see the Idaho Central Health District has pretty well put away the threat that one restaurant worker caused at Boise's Red Feather Lounge by working with Hepatitis A.  Here's what that Idaho agency told the public:

It has now been two weeks since the Red Feather Lounge employee with hepatitis A last worked at the establishment. Anyone potentially exposed to the disease between March 5th and 17th will no longer be eligible for a vaccination because it would not be effective. From March 25th through March 31st Central District Health Department (CDHD) provided hepatitis A vaccinations to 283 people. Everyone potentially exposed should continue to wash their hands thoroughly, since receiving hepatitis A vaccine after a potential exposure is not 100% effective prevention. CDHD reminds those that have not been vaccinated or have not been previously infected to watch for signs of hepatitis A infection. CDHD still maintains that the chance of infection is low, but patrons should be aware of the following information.

It goes on to provide excellent write-ups on symptoms, incubation, treatment, and statistics.  Go here for all of that.

As that ends in Idaho,  the Lafayette, Louisiana Parish Schools is confronting the same problem as one of its employees continued working after contracting Hepatitis A.   KLFY-TV 10 is reporting that vaccinations will be available on Wednesday April 9th at these three sites: Acadian Middle, NP Moss at Good Hope Baptist and NP Moss Annex.  The vaccines are free of charge for all students and faculty attending those schools

KLFY-TV 10 reports:

Hepatitis A is serious contagious liver disease. Now hundreds of students in Lafayette are exposed to it.

We will see how Louisiana handles it.  At this point, we haven't seen any involvement by either the state or the Region 4 Health District.   Maybe they just leave it to the Parish Schools.

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Anyone who consumed ice, beverages with ice, ice cream or lemons at the PF Chang's in West Chester, Ohio anytime between March 14 and 25 should see their doctor immediately.

A restaurant worker with Hepatitis A was on the job then, putting everyone consuming one of those items in danger, according to the Butler County Health Department.  The Kypost reports tonight (3/28/08) on the alert about the Hepatitis scare.

Go here for that report.

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Dozens of people are showing up at the Central Health District in Boise, ID for shots, either vaccines or immune globulin.   All are patrons of the Red Feather Lounge, a trendy spot in downtown Boise, and they were served in the establishment sometime between March 5 and 17 when they might have been served by a restaurant worker who was contaminated with Hepatitis A.

The online Argus Observer reports that:

While the risk to the public is low, lounge patrons possibly could have been exposed, David Fotsch, public information officer for the Central District Health Department, said in an announcement released Tuesday. Central and Southwest District health departments are recommending people not immune to hepatitis A who had food or a drink at the Red Feather Lounge during the specified dates receive hepatitis A vaccines or immune globulin immediately. They should also contact their health provider if they are showing any symptoms of hepatitis, Fotsch said.

For more from the Argus, go here.

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On April 1st,  North Dakota will require children in daycare to have vaccines for Hepatitis A, Pneumococcal, and Rotavirus.

KFYR-TV took a look at how its going with the deadline fast approaching.  The Bismark station reports:

"Well most of the kids have the pneumonia one, some of the small ones have the Hepatitis A one, but very few have the rotavirus one," says Renae Vilhauer, of King`s Kids Daycare.

Bismarck-Bureleigh Public Health says that`s because the rotavirus vaccine has only been available for two years. It must be given to a child by the time he or she is eight months old, meaning a child who is three has never, and will never get the chance to receive the immunization.

The State Health Department says it`s up to the daycare to enforce the immunization deadline.

Vilhauer told KFYR-TV that although the immunizations will be required by the state, asking, instead of ordering, parents to immunize their children is really all that can be done. 

Check here for the complete story on KFYR-TV.

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Ok, this is a familar story.  Only because the names of some of the people involved has an Hepatitis A scare turned into a national story. 

It seems movie star Demi Moore threw a party for her boyfriend, Ashton Kutcher, on Feb 7th at a Manhattan bar called Socialista.  The guest list included the likes of MADONNA, BRUCE WILLIS and GWYNETH PALTROW.

Trouble is New York City health officials says anyone who went to the Socialista after 8 p.m.on Thursday February 7th or Friday February 8th, or after 10 p.m. Monday, February 11th is at risk because a bartender working there has active case of Hepatitus A.

Anyone who might have been exposed to him should be vaccinated to keep from developing the disease.

NY1 News reports that:

Symptoms of hepatitis A include fatigue, poor appetite, fever, and vomiting. Some people may have darker urine or jaundice, which is a yellowish tinge to the skin.

As many as 700-800 people may have visited the bar during those dates and times. People who may have been exposed but have already had two doses of hepatitis A vaccine at some point in their life do not need another shot. But health officials say everyone else should be vaccinated.

The Health Department will provide free shots at P.S. 41 elementary school on 116 West 11th Street at Sixth Avenue for people who may have been exposed at the following times: Friday, February 22 from 4 p.m. - 10 p.m.; Saturday, February 23 from 1 p.m. - 8 p.m. ;and Sunday, February 24 from 1 p.m. - 6 p.m.

Go here for more from NY1 News.  Oh, and don't expect to see Demi or any of her pals in line for the shots.  Doctors do still make house calls for the rich and famous.

 

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The County Executive in Buffalo, NY has decided it will take at least another day to vaccinate all the people exposed to an employee with Hepatitis A who was working at a local Wegmans store.

Wegmans is a Rochester, NY chain of eco-friendly outlets with a grocery store/ restaurant combination.   They are much Whole Foods, which recently took over Wild Oats, and Seattle's late, great Larry's Markets.

The store involved in this Hepatitis A scare is located at 5275 Sheridan Drive in Buffalo.

If you purchased produce at this Wegmans location after January 7, 2008, and ate this produce without cooking since January 26, 2008 and have not been previously vaccinated or had Hepatitis A illness in the past, the Erie County Department of Health is recommending a Hepatitis A vaccine or immune globulin (IG).

Erie County Executive Chris Collins said vaccination clinic held Monday (2/11) on the ECC North Campus from 12:00 p.m. until 8:00 p.m. Collins told WBEN that officials will make evaluations throught the day to see if any additional clinics will be needed.

The WBEN story can be found here.

 

 

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Michele Young of the Kamloops Daily News, wrting in the Vancouver Sun, over the weekend reports that two incidents of Hepatitis A are being investigated by health officials.

One victim, who recently visited Mexico, is a member of a local sports team.   The other is a restaurant worker who was in India recently.  The food handler worked at the Sun Peaks restaurant Mesa's Bar and Grill.

Young's story in the Sun said:

The incidents are unrelated, (Dr. Digby) Horne said. "We don't really know how they got the hepatitis A. Possibly food or water," he said. Neither of the infected people are in hospital, and the food handler is feeling better.

The teenage sports player, however, is still sick. He began showing symptoms Jan. 23 and a lab confirmation of hepatitis A was made Thursday.

"We're still working on identifying or checking to make sure there aren't any more contacts, but we did immunize team members because there had been significant food handling and sharing," said Horne.

For all of Ms. Young's story, go here.

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The on line HealthDay News of the American news magazine, U.S. News & World Report, is filled with stories and information on food-borne illnesses stemming from imports.    It  includes the story of the largest Hepatitis A outbreak in U.S. history and updates the progress that one of the seriously injured victims is making five years later. 

One Sunday after church, Rich Miller headed to a local Chi-Chi's restaurant in Beaver, Pa., where he dipped into the house salsa that came with the meal.

That simple act in 2003 changed his life forever. What Miller didn't know was that imported Mexican green onions in the salsa carried a deadly passenger: hepatitis A.

A few days later, as Miller recalled recently, "I couldn't even get out of bed. It was like the worst case of flu that you could ever imagine."

His health quickly deteriorating, the 57-year-old railroad superintendent was diagnosed with rare fulminant hepatitis A disease -- in which the virus destroys the liver -- and was rushed to a Pittsburgh hospital for a liver transplant.

Placed in a medically induced coma for a month, Miller eventually returned home, frail and unable to return to work. To this day, he said, he has mobility problems and neurological difficulties.

Still, Miller considers himself lucky: Four others who ate the salsa and developed fulminant liver illness died. Overall, more than 600 people around Pittsburgh were sickened during what became the largest hepatitis A outbreak in U.S. history

The Mexican green onion outbreak at Chi- Chi's came a month after the restaurant chain had filed for bankruptcy.  In 2004, it was forced to shut-down entirely, selling off some of its choice properties to Outback Steakhouse. 

Marler Clark represented many of the victims, including the 9,489 people who got inoculated because of  they were exposed to Hepatitis A at the Beaver Valley Mall Chi-Chi's.  News reports at the time said Seattle-based Marler Clark won millions for its clients in the deadly outbreak, including $6.25 million for Mr. Miller.

Although some of its sites were cherry-picked for use by Outback and others, many abandoned Chi-Chi's remain around the country.

Chi-Chi's line of grocery products, which was big on its salsa, was sold to Hormel.  If Chi-Chi's demise has left you wishing you could still get its salsa, Wikipedia, the free encyclopedia, provides this recipe:

"Salsa"

Chi-Chi's fresh hot Salsa can easily be replicated with fresh tomatoes, red onions, fresh cilantro, serrano peppers, banana peppers, lime juice and salt. This is actually a "pico" sauce but Chi-Chi's sold it as their fresh salsa. It replaced the standard hot salsa and was served in its place.

The actual recipe from the Chi-Chi's food manual (for the Hot / Pico Salsa ) is as follows:
(Adapted to make 30 servings, Actual recipe made 120 servings)

1 Serrano pepper stemmed & chopped (leave seeds in for more "heat")
3 tsp fresh cilantro
2 TBS sweetened lime juice (Rose's Lime Juice)
2 tsp salt
4 tomatoes chopped drained
1/2 large red onion chopped
1/2 banana pepper chopped
1/2 red pepper

 

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You may recall that last August, there were pictures of President Putin hunting and fishing in Tuva.

We not think these events are in anyway connected, but now comes word of a Hepatitis A outbreak in Tuva's Todzhinsky Kozhuun District.

Russia's NewsLab is reporting that 34 children have tested positive for Hepatitis A; and 900 other children have had contact with them.

Twenty five water sources have been tested for the virus, 5 of them were detected as infected, Lyubov Oorzhak, Tuva's chief sanitary official said. Immunization of children has already been carried out in the villages, where the outbreak of the disease had been registered.

Nikolay Mongush, head of Tuvan Agency for Civil Defense and Emergencies, was reprimanded for failure to take measures and inform the executives of the republic about the situation.

400 doses of a vaccine were sent to Todzhinsky District today. The Russian news service said extra money will be required for re-vaccination. Ministry for Finances was asked to find the required funds. 

Whether Tuva remains Putin's vacation spot remains to be seen.

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Oregon, it appears, will become the 11th state beginning in the Falls of 2008 to require children in preschool, childcare facilities, kindergarten and Head Start to have two doses of Hepatitis A vaccine.

Over the next few years, Hepatitis A vaccine requirements will be added to other grade levels in Oregon. 

Oregon allows two types of immunization exemptions: one for religious purposes, which requires a guardian signature, and the other for medical reasons, which requires a physician or a health department official signature.

According to a report by the Centers for Disease Control & Prevention, Alaska, Arizona, Georgia, Missouri, Nevada, New Mexico, Oklahoma, Tennessee, Texas and Utah currently include Hepatitis A vaccines in their school immunization requirements.

California strongly recommend children get vaccine shots for Hepatitis A, but do not require them.

About 180,000 people become infected annually with the Hepatitis A virus, and about one third of those are children.

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As soon as he finishes writing newspaper stories on the convicted Dr. Robert Stokes, Ken Kolker at the Grand Rapids Press should start on a script for "Law & Order."

This strange story would be weird for New York City let alone mild and mellow Grand Rapids, Michigan.   So far, this story does not involve Hepatitis A, but Hepatitis C.  But its interesting nevertheless.  Here's the nitty-gritty of the story.  Dr. Stokes allegedly reused medical equipment meant for one-time use, including syringes and sutures.  He was sentenced on Dec. 27 to 10 and one-half years in federal prison for $1.9 million in insurance fraud that was not related to his  allegedly unsanitary medical practices.

In the meantime, however, public health officials in Michigan are encouraging Dr. Strokes 13,000 patients to get tested.

Thus the New Year's Day edition of The Grand Rapids Press reported that:

"The results of blood tests are trickling in for former patients of Dr. Robert Stokes, the disgraced dermatologist whose medical practices allegedly posed a risk for the spread of communicable diseases.

 "So far, six former patients have tested positive for hepatitis C, state health officials said. The officials say in terms of percentages, the overall results have been encouraging, though it still is too early to draw conclusions.

"Officials have received test results for 710 of the doctor's 13,000 or so patients in Kent and Montcalm counties. Many have yet to be tested. "

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A worker at a Calgary, Alberta, Canada McDonald's restaurant has been diagnosed with hepatitis A, and in an effort to prevent an outbreak, public health officials are offering immune globulin injections to inoculate customers against the hepatitis A virus.

Anyone who ate at McDonald's less than 14 days ago is eligible to receive the injection.

This week's food safety infosheet from the International Food Safety Network provides additional information about the hepatitis A exposure.

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The latest news on available supplies of pediatric and adult formulations of hepatitis A vaccine, inactivated, is mixed. Of the two manufacturers that produce this vaccine for the U.S. market, one reports that it has temporarily ceased taking orders for vials of the vaccine, and the other states that its current production and supply levels are in good shape to handle demand for the product.

That's according to a Sept. 28 update posted on the CDC's Current Vaccine Shortages & Immunizations Web page, which further notes that no changes in current recommendations for administration of hepatitis A vaccine are indicated at this time.

keep reading here

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A second student has been diagnosed with Hepatitis A at a Fishers grade school, authorities said today.

Classes at Harrison Parkway Elementary were not dismissed because of today's discovery - the second case this month - but letters explaining the disease were sent to parents, said Hamilton Southeastern School Assistant Superintendent Richard Hogue.

"The health department told us there was no reason to shorten the school day," Hogue said.

Keep reading here

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SAN JOSE, Calif. -- Jamba Juice's CEO responded Thursday to a hepatitis A scare originating at a Willow Glen location.

Santa Clara County Public Health Department said Thursday there might have been exposure to hepatitis A at a San Jose Jamba Juice, located in Willow Glen at the corner of Willow and Lincoln avenues

Santa Clara County Health Officer Dr. Marty Fenstersheib told NBC11 a worker came down with hepatitis A in August.

He said because the worker came in contact with food, he is issuing a warning to customers. Fenstersheib said anyone who went to that restaurant and has certain symptoms should see his or her doctor.

Keep reading here.

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As I lay huddled on a lumpy bed in a guest house in Dharamsala, India, still recovering from giardia, I listened to the infant in the room next door scream for hours.

Was he suffering from a similar parasite, dysentery or food poisoning, or was he just colicky? I never found out, but my husband and I promptly checked out, vowing to never bring a newborn to a country where flies are more numerous than diners inside restaurants.

keep reading here.

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The number of cases of Hepatitis in Kern County California is increasing at an alarming rate.  According to new statistics released by the Kern County Department of Public Health, Hepatitis A cases have increased 10-fold from six this time last year to 64 this year.  Hepatitis A is most commonly transmitted due to bad hygiene.

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The Salem Hooters, at 327 S. Broadway, opened only three years ago. In May 2005, an employee there was taken to the hospital with hepatitis A, but state officials said diners at the restaurant were never at risk.

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A former worker at O'Charley's Restaurant has been linked to the Hepatitis A outbreak in Lexington.  Full Story

Officials say the worker most likely contracted the virus out of state.
At this time, only three people have been linked to the outbreak, but not from eating at the restaurant.   Never the less, for the next week anyone who ate at the O'Charley's on Richmond road is being asked to monitor their health.

Officials say, that symptoms of the disease could occur at anytime.
Symptoms of the disease include diarrhea, flu symptoms, and even in the most serious cases jaundice.

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Anyone who has visted Earthhaven in McDowell County around May 25 is being prompted to seek treatment from a physician due to possible Hepatitis A exposure.  Full Story

Carolyn King, health education supervisor with Wayne County Health Department, said the treatment is to be vaccinated with a shot of immune globulin. If received within two weeks of exposure, symptoms of Hepatitis A are more unlikely.

Hepatitis A, or HAV, is a liver infection and the most common type of viral hepatitis, she explained. It usually causes temporary liver inflammation and most recover without long-term problems. The virus can be spread for at least two weeks before symptoms develop.

Symptoms may include jaundice, fatigue, abdominal pain, loss of appetite, nausea, diarrhea and fever. They usually last less than two months.

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One person has tested positive for Hepatitis A after being in contact with the Earth Haven Eco Village in North Carolina. Full Story

Rutherford Polk McDowell District Health Department spokeswoman Debbie Goings said anyone who has had contact with the Earth Haven Eco Village, a natural living commune, from May 25 until the present should call the health district at 925-0530.

Goings also said that people who think they have been infected can receive a globulin injection at the McDowell Health Department from 8:30 a.m. to noon tomorrow. The health department is located at 408 Spaulding Road in Marion.

Goings said along with the one person who has tested positive, three others are thought to be positive based on their symptoms and two other people are suspected to have the disease.

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KHTS News, Sunday, 20 May 2007
Mandatory Hepatitis A vaccinations being pushed by County board Full Story

To counter legal roadblocks preempting the County from imposing mandatory Hepatitis A vaccinations for food service workers, the Los Angeles County Board of Supervisors unanimously approved Supervisor Michael D. Antonovich’s motion to sponsor State legislations amending the California Retail Food Code to mandate such vaccinations for public health.

Today’s action follows on Supervisor Antonovich’s previous motion to require Hepatitis A vaccinations for food service workers. On May 3, 2007, County Counsel discovered that the County is prevented by State law from imposing a universal vaccination requirement for food service workers.

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Thirteen people contracted Hepatitis A after eating raw oysters in Arizona between March 8 and 25.  Full Story from Diana Suarez at Bajo El Sol

Health officials are warning people not to eat raw shellfish after 13 Arizonans, one of them a Yuma County resident, contracted hepatitis A from eating uncooked oysters at Rocky Point, Son., in March. "These cases are a reminder that there is a real risk of getting sick from uncooked shellfish, regardless of where it came from," state epidemiologist Ken Komatsu said in a news release.

"Our warning is consistent with what the state is doing," added Benito Lopez, epidemiologist with the Yuma County Health Department.
"Avoid consuming oysters, clams and all shelled seafood that is raw. That is the recommendation."

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Another person has been diagnosed with Hepatitis A in Minnesota. Last week, over 2,000 shots were administered after 3 people were diagnosed with the virus.  Full story.

BURNSVILLE, Minn. (AP) - One person at Burnsville High School has been diagnosed with hepatitis A and about 20 others may have been exposed, school officials warned Thursday.

Preschoolers and high school students were exposed through food preparation in a preschool class at the high school, the Burnsville-Eagan-Savage School District said. The district said the parents of those children were sent a letter and called about the incident.

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Long Beach Island health officials are urging local restaurants to take advantage of the hepatitis A vaccine offered at the health department.  Full Story

Health officials on Long Beach Island are concerned that local food-service workers are not being vaccinated for the liver disease hepatitis A and that the transitory nature of the employees, mostly immigrants, makes doing so a difficult task.

Tim Hilferty, director of the Long Beach Island Health Department, said administering the vaccine is not a priority for local business owners.

“There hasn't been a lot of interest in the vaccine. It's not really a priority, because the vaccine is just recommended and not required by law,” Hilferty said.

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The Arizona Department of Health Services and the Maricopa County Department of Public Health have confirmed 11 cases of hepatitis A in Maricopa County. All reported eating raw oysters in Puerto Peñasco (Rocky Point) in March and are recovering.  Two additional cases were discovered statewide, one each in Pima and Yuma counties.  Mexican health officials are investigating possible sources of the contaminated oysters, as they were eaten at various locations including an oyster farm, street vendors and at the beach.

"These most recent cases are a reminder that eating uncooked shellfish is the same story as with meat and poultry—if you eat it raw or undercooked, there is a real risk of getting sick with some pretty nasty bugs," said Dr. Bob England, Director of the Maricopa County Department of Public Health.  Illness resulting from hepatitis A infection may include fever, fatigue, loss of appetite, nausea or abdominal discomfort, which may be followed within a few days by jaundice. Hepatitis A can take from 15 to 50 days to develop, however it usually takes about 30 days. The illness is rarely fatal, and is usually of mild to moderate severity.?

“Our investigation leads us to believe that these 11 people were exposed from mid to late March,” said Dr. England. “Anyone who has traveled to Mexico during this time or subsequently and who develops the above symptoms should consult with their health care provider.”  Due to a higher risk of complications, anyone with another form of hepatitis or underlying liver disease and who ate raw oysters in Puerto Peñasco during this time may wish to consult with their health care provider.
According to the Centers for Disease Control and Prevention, people traveling to countries where hepatitis A is common should consider getting immunized. There is an effective vaccine that virtually eliminates the possibility of getting hepatitis A.

Hepatitis A is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. To avoid contracting hepatitis A, always wash your hands after using the bathroom, changing a diaper, or before preparing or eating food.

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Slayton hepatitis A outbreak update
Clinics serve nearly 2,300 people; restaurant reopens; investigation continues

More than 2,280 people received immune globulin (IG) shots at two public clinics held in Slayton, MN on Friday and Saturday after health officials learned of cases of hepatitis A illness in two food workers at the Pizza Ranch restaurant earlier in the week. Those receiving the shots were people who may have been exposed to hepatitis A through food eaten at the restaurant from April 20 through May 1. The shots, if given within 14 days of exposure, will prevent symptoms of hepatitis A infection.

The restaurant reopened Monday after management complied with all of the conditions required by health officials for reopening. Those requirements included exclusion of all ill foodworkers from working until they recover fully (and are no longer infectious), all other foodworkers receiving immune globulin shots, employee training in various procedures aimed at preventing contamination of food handled by workers, a thorough cleaning of the restaurant and replacement of all ready-to-eat foods.

No additional public IG clinics are planned at this time. According to John Schuh, administrator of the Lincoln, Lyon, Murray, and Pipestone Public Health Services, the vast majority of people from the Slayton area needing IG were served by the two clinics. While it appeared early on Saturday that an additional clinic may be needed, demand tapered off after noon on Saturday, but the entire allotment of IG was used.

People who have concerns about their possible exposure or about needing immune globulin should consult their health care provider. The Minnesota Department of Health will continue to operate a toll-free line during regular business hours Monday through Friday for people who have questions about hepatitis or the outbreak. That number is 1-877-676-5414.

As of Monday, May 7, there are four confirmed cases of hepatitis A in this outbreak: three among food workers and one in a patron of the Pizza Ranch. MDH will continue to investigate current cases of illness and any future possible cases. Additional cases of illness may yet occur because some people may have been exposed before April 20 and did not receive IG. The source of the hepatitis A is still under investigation.

Hepatitis A is an infection of the liver caused by HAV, but does not result in a chronic infection. Adults generally experience acute symptoms, particularly headache, fever, tiredness, loss of appetite, and nausea. Dark (tea or cola-colored) urine, light-colored feces (stool), and yellowing of eyes or skin (jaundice) may appear a few days later. Young children generally do not have symptoms. Rarely, hepatitis A can lead to very severe liver disease. Most people who have hepatitis A get well on their own after a few weeks, but may need to rest in bed for several days or weeks.

There is a very effective vaccine that protects against infection with hepatitis A virus (HAV). Careful hand washing after using the toilet, after changing a diaper, and before preparing or eating food will prevent the spread of HAV.

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There have been 3 confirmed cases of hepatitis A after the outbreak at a Pizza Ranch restaurant in Minnesota. The health department gave nearly 2,300 shots to the public on Friday and Saturday.  Full Story by Dana Yost from the Marshall Independant.

Three cases of hepatitis A have been confirmed, the state health department said Friday. Two cases involve employees, and a third was a customer of the Pizza Ranch, said MDH spokesman Doug Schultz. Because a customer was infected, it made it likely more cases would turn up, Schultz said.

Schuh said 1,375 shots were given as of 7 p.m. Friday. More than 900 were given Saturday.

He said health officials were given 1,800 vials of IG from the state, but were able to stretch the doses to 2,289 because doses are based on an individual's weight.

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The Pizza Ranch Restaurant restaurant in Slayton, Minnesota is being investigated after two food workers tested positive for hepatitis A.  Full story

SLAYTON, Minn. The Minnesota Department of Health is investigating a possible hepatitis A outbreak in Murray County in southwestern Minnesota.

Two food workers at the Pizza Ranch restaurant in Slayton have tested positive for hepatitis A. Test results on several other employees may be available as early today.

The restaurant voluntarily closed Tuesday as a precaution.

Slayton Hepatitis Shot Clinic Will Not Resume

(AP) Slayton, Minn. Nearly 2,300 people received immune globulin shots for hepatitis A over two days after two workers at a Pizza Ranch restaurant in Slayton became ill with the disease, a health official said Sunday.??Public health will not provide additional shots and anyone wanting a shot should check with their doctor, said John Schuh, the administrator of Lincoln Lyon Murray Pipestone Public Health.

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Heather Ann White of the Corpus Christie Caller-Times reported that the Stores in question are in Harlingen and Raymondville

The Texas Department of State Health Services issued a warning Tuesday to anyone who ate at the Harlingen restaurant at 1605 W. Harrison St. between March 1 and 12 and its Raymondville restaurant at 1007 E. Hidalgo Ave. between March 13 and March 31 to seek medical treatment for hepatitis A if experiencing symptoms. An employee working at both restaurants was diagnosed with the virus and could have spread the disease, said Emily Palmer, health services spokeswoman.  Whataburger officials said Tuesday that it was an isolated incident. Palmer said no other cases have been confirmed, but symptoms could show up as late as 28 days. Customers who visited either restaurant after March 31 are not in danger of contracting the disease.

We have been contacted by counsel for Whataburger.  They seem quite concerned for their customers.

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Two students from Milford High School in New Hampshire have been diagnosed with Hepatitis A. Health officials are investigating the source.  Full story

CONCORD, N.H. --Two Milford High School students were recently diagnosed with Hepatitis A, virus the state Department of Health and Human Services said Thursday in a letter sent to parents.

The letter said it's important to be aware of the signs and symptoms of an infection,which include an abrupt fever, loss of appetite, abdominal pain, dark colored and urine and/or clay-colored stools, and jaundice.

In general, illness is not severe and those who are infected recover fully, Jose Montero, the state epidemiologist, said in the letter. Older children and adults may have symptoms that usually last several weeks.

The virus is contagious two weeks before symptoms start, until one week after they are resolved. Immunoglobulin is given within two weeks of exposure can prevent the disease from developing if exposed.

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Reported by Anabel Marquez

Texas State health officials said anyone who ate at the restaurant located on Harrison Street in Harlingen between March 1st and March 12th, or the Whataburger located on Hidalgo Street in Raymondville between March 13 and March 31st, may have been exposed to the dangerous virus.

Hepatitis A is a viral infection of the liver which health experts say requires immediate medical attention. The Texas Department of State Health Services released a statement indicating an employee who worked at two Valley restaurants has been diagnosed with the disease.

According to the health department, the symptoms may include fever, fatigue, loss of appetite, nausea, vomiting and abdominal discomfort. But, experts say the time between exposure and symptoms may take up to 28 days. Symptoms usually last 2 weeks, but can last longer and young children with Hepatitis A often have no symptoms.

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Full Story from The Associated Press - April 13, 2007
EAU CLAIRE, WISCONSIN — Health officials vaccinated children, staff and parents Friday at a preschool potentially linked to cases of hepatitis A in three parents.

“This action is being taken to protect the health of parents, preschool staff and children who may have been exposed to hepatitis A and to prevent further infections and the spread of the disease in the community,” said Richard Thoune, Eau Claire City-County Heath Department director.

Hepatitis A is a liver disease caused by a virus. It is most often found in children, according to the state Department of Health and Family Services.

Parents from two families with children in preschool at Trinity Lutheran Church are doing fine after being treated for the disease, Thoune said. They did not require hospitalization.

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Pappasitos Cantina restaurant in Houston is offering customers who were exposed to the hepatitis A virus cash and gift cards in exchange for signing a release that would discharge them from any lawsuit connected to the outbreak. Full story

The customer then received an offer of $300 in cash and two $50 dining cards to compensate him for the inconvenience.

"They were quite anxious to get this signed and back in their hands, so that certainly concerned us," the customer said.

In order to get the money, Pappas wants customers to sign a document that would "fully release and discharge Pappas Restaurants from all claims suits … connected with any alleged exposure to hepatitis A at Pappasitos Cantina."

The release said the terms of the agreement are to be held in strict confidence.

"They do this because they don't want the bad publicity," Waldman said.

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Hugh Grant and Drew Barrymore might think twice before indulging in the nibbles at future parties, after being informed that they may have been exposed to Hepatitis A at a recent bash for their new film, Music And Lyrics.  The Music And Lyrics party was one of 14 events catered for by the Wolfgang Puck catering company using a cook who was discovered to have Hepatitis A, according to TMZ.com, which obtained a letter sent out to guests warning them of the risk of exposure to the virus.  Other high profile guests at the February 7 bash included Sandra Bullock, Adam Brody, Jimmy Fallon and TR Knight.

The sponsors of the party told TMZ.com that the Department of Public Health didn't alert them to the problem until February 28, seven days after the two week window in which those who risked infection could have been vaccinated against developing the virus.  The party's sponsors say that, as far as they know, no-one is known to have contracted Hepatitis A from the event.  The letter urges guests to recall whether they ate any uncooked food served at the event, going on to describe "how very low the risk of infection is".

The LA County Department of Public Health went public with only one other event catered for by the Hep A-carrying cook between February 3 and February 20 - a Sports Illustrated attended by stars included Beyonce - but did tell TMZ.com that several of the events in question were "hosted by extremely high profile people" who have been notified privately about the scare.

I can see it now - 'BILL MARLER, LAWYER TO THE STARS"

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A Vacaville restaurant is being investigated by the Solano County Health Department after reports of Hepatitis A outbreak.  Five customers became sick after eating at BJ's Brewhouse in mid-January of this year.  Their symptoms included fever, vomiting, and diarrhea. No workers at the restaurant tested positive for the disease.  Health officials say the incubation period has passed.  Dr. Ronald Chapman, Solano County Health Director, encourages everyone to wash their hands and be careful with all types of food preparation

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A manager at a Katy ice cream shop has tested positive for hepatitis A, marking the second time this year an employee at a Houston-area food service business has been infected with the disease.

Marble Slab Creamery was locked Friday and a bright orange sign on the door warned that customers who have eaten products from the 23270 Westheimer Parkway store between Feb. 1 and Feb. 25 may have been exposed.

•Report suspected cases to the Fort Bend County health office at 281-342-6414 or by fax at 281-342-7371.

• Symptoms: Extreme fatigue, fever, nausea, vomiting, stomach pain or diarrhea, light-colored stool, dark or rust-colored urine, jaundice

• Treatment: Antibody shots to prevent the virus from causing a liver disease. Shots are only effective for two weeks after infection.

Source: Fort Bend County Health and Human Services Department
Continue Reading...

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CBNNews.com -- LOS ANGELES (AP) -- Thousands of food service workers in eateries across Los Angeles might be vaccinated for hepatitis A because of a series of outbreaks of the disease.

Los Angeles County supervisors voted unanimously Tuesday to look into the costs and benefits of requiring vaccination of more than 100,000 workers at 25,000 eateries, 300 catering companies and 270 wholesale producers.  "We need to ensure that those who are involved in the handling of food are safe and healthy," County Supervisor Mike Antonovich said. "The public is vulnerable."

The vaccinations cost about $200 per person (Actually I think it is closer to $20).  Other cities already require the shot, including Las Vegas and St. Louis.

Last month, a cook at the Wolfgang Puck catering company was diagnosed with hepatitis A. Health officials issued warnings to 3,500 people who attended more than a dozen events catered by the company, including a Sports Illustrated bash celebrating the magazine's swimsuit issue.  That was among roughly 800 cases of hepatitis A in the city in the past two years.

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Beyonce Knowles is free of hepatitis A as she did not eat any food at the party held to celebrate Sports Illustrated's Swimsuit Issue, mews media reports.

"Thank goodness, neither one of us ate. According to the health department, she wasn't at risk," her publicist Alan Nierob was quoted as saying by news reports.

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SEATTLE (February 28, 2007) - The attorneys at Marler Clark, the Seattle law firm nationally known for its successful representation of victims of foodborne illness, are once again calling on restaurants and caterers nation-wide to vaccinate employees against hepatitis A.  The call comes after reports that an employee of Wolfgang Puck Catering was diagnosed with an acute hepatitis A infection; the employee reportedly worked at nearly a dozen events, including the Sports Illustrated swimsuit issue party on February 14.

Guests who ate raw food at events catered by Wolfgang Puck Catering between February 14 and 20 were encouraged to receive Immune globulin injections to prevent becoming infected with hepatitis A. Because Immune globulin is only effective within fourteen days of exposure, today was the last day for guests at the Sports Illustrated swimsuit issue party on February 14^th to receive their inoculations. 

“This most recent exposure comes on the heels of other exposures around the country, and provides further support for mandatory hepatitis A vaccinations for all foodservice workers,” said William Marler, managing partner of Marler Clark. “In the first two months of 2007, thousands of restaurant patrons have been exposed to hepatitis A and have been forced to stand in line at health department clinics or contact their health care providers to prevent an infection that they never would have been exposed to in the first place if food workers were vaccinated against hepatitis A industry-wide.”

In 2006, the Centers for Disease Control and Prevention recommended that all children be vaccinated against hepatitis A.

“While the CDC recommendation is a start, it will be many years until the kids receiving those vaccinations become restaurant workers,” Marler continued. “It is in the restaurant and food service industry’s best interest to vaccinate all workers against hepatitis A now.”

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LOS ANGELES — An employee of Wolfgang Puck Catering diagnosed with the hepatitis A virus may have exposed guests at several events, including Sports Illustrated's swimsuit issue party, health officials said.

The risk of illness was "quite low," but anyone who ate raw food at the magazine's Feb. 14 party was urged to receive a preventive shot by Wednesday, the Los Angeles County Department of Public Health said Tuesday.

The virus is found in the feces of infected people and can be spread through contaminated food and water. It attacks the liver and can cause fever, diarrhea and jaundice. It is rarely fatal.

The affected employee was placed on medical leave, said Carl Schuster, president of Wolfgang Puck Catering.

keep reading here

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LOS ANGELES (Reuters) - A Sports Illustrated bash for its annual swimsuit issue has turned into a health scare for stars in Hollywood after a caterer working for celebrity chef Wolfgang Puck may have exposed them to acute Hepatitis A.

The Los Angeles County health department recommended on Tuesday that anyone who ate uncooked food at the U.S. sports magazine's party on Feb. 14 get treatment by Wednesday to avoid developing the serious liver disease.

Guests at the party included singer Beyonce Knowles, former Guns N'Roses bassist Duff McKagan, portly "Borat" co-star Ken Davitian, and a slew of models.

Health officials said the risk was "quite low" and that no Wolfgang Puck pre-packaged foods or restaurants were affected.

Keep reading here.

Other Stories:
www.khou.com/news/local/stories/khou020727_mh_beyoncehepatitis.349864e.html
and
www.pr-inside.com/knowles-amp-rafaeli-at-risk-of-r57206.htm

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A mother reacts to a Hepatitis-A scare at a Roanoke daycare.

The Alleghany Regional and Roanoke Health Districts sent a letter home to parents who's children go to First Baptist daycare. The Health Department says two children there were infected with Hepatitis-A.

One parent who does not want to be identified, says it worries her because it's happened here before.

Keep reading here

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More than 2,000 people received free antibody shots to fight off hepatitis A after learning an employee at a north Harris County Pappasito's Cantina was infected with the disease, county health officials said.

Harris County Public Health and Environmental Services had issued a health advisory for any customers who had eaten at the restaurant since late January.

People exposed to hepatitis A can be treated with antibodies, but they must receive shots no later than two weeks after exposure.

Keep Reading here

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Parents whose children attend First Baptist Child Development Center in Roanoke, received a letter on Friday that their children may have been exposed to Hepatitis A.

The letter from the health department stated that two children had developed Hepatitis A. It is easily transmitted among young people, especially those in diapers.

The health department plans on coming to the daycare center next week to give out vaccines.

Keep reading here

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Georgia students who expect to attend sixth grade this fall are going to have to roll up their sleeves again. The Georgia Department of Human Resources board has approved a new immunization schedule for schoolchildren, based on recommendations from the federal Advisory Committee on Immunization Practices.

Among the changes: Kids entering sixth grade will need booster shots for chicken pox and mumps; preschoolers will need to be vaccinated against a certain type of pneumonia; and all children born after Jan. 1, 2006, must be immunized against hepatitis A.

The immunization certificate required in order to attend Georgia schools is being revised based on the new recommendations. Copies of the form will be available from pediatricians and public health departments by Thursday.

Representatives from the Gainesville and Hall County school systems plan to meet with public health officials next week to discuss the new requirements and how to make people aware of them.

Keep reading here

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HOUSTON -- More Houstonians who may have been exposed to hepatitis A at a local restaurant got immunization shots on the second day they were offered, KPRC Local 2 reported Wednesday.

Hundreds of people who worked or dined at Pappasito's Cantina on the North Freeway near Airtex Drive have been vaccinated after an employee was diagnosed with the disease.

Those that went to the center on Wednesday experienced much shorter wait times than the day before, when many waited up to three hours to get their immunization.

keep reading here

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What is Hepatitis A?
Hepatitis A is a liver disease caused by the Hepatitis A virus. This virus is a gastrointestinal virus. If you have ever had Hepatitis A you can not get it again.

How can you be exposed to the Hepatitis A virus?
Anyone can be exposed to the Hepatitis A virus. Hepatitis A virus is found in the stool of an infected person. The Hepatitis A virus is spread by close personal contact with someone who has the infection. People more likely to have close personal contact with an infected person would be:

--children and adults attending or working in day care centers where an infected person attended or worked

--household contacts of infected persons

--eating food prepared by an infected person

--sex partners of infected persons

--persons traveling in countries where Hepatitis A is common

Keep reading here

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A Seattle, Wash., law firm is representing a woman in a class action lawsuit against a Geneva restaurant as a result of a potential outbreak of the hepatitis A virus.

The suit was filed on behalf of Rebecca Johnson of Genoa, in DeKalb County, and patrons who dined at Houlihan's Restaurant between Jan. 8 and 19 and were subsequently advised to receive preventive shots after a restaurant employee tested positive for hepatitis A. Hepatitis A can potentially cause liver damage.

"It looks as though the quick action of the Kane County Health Department will likely prevent hepatitis A illnesses. This represents people that have experienced worry and disruption from time off work or the cost of a doctor's visit," attorney David Babcock said.

Babcock is a member of the Seattle firm Marler Clark Attorneys at Law, which has undertaken national food-borne illness cases.

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This is the third reported incident of Hepatitis A in a food service worker in the last two week - Arizona, Illinois and now Rhode Island.

Providence Journal

The Health Department is giving shots to 320 employees of the Cheesecake Factory in Providence and the Texas Roadhouse in Cranston after a busboy who worked at both restaurants was found to be infected with hepatitis A.

The busboy apparently picked up the virus, which affects the liver, on a trip to South America. Health officials are convinced that he did not have an opportunity to pass the infection to patrons. He cleared tables and did not handle food.

But his co-workers could have caught the bug from him, so the Health Department is offering injections of immune globulin to all the workers at both restaurants. The injections infuse antibodies against hepatitis A into the body and prevent illness.
Continue Reading...

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Full story Paul Dailing at the Kane County Chronicle (IL)

GENEVA – Attorney William Marler of Marler Clark Attorneys at Law was cited as saying that a family of four from Geneva contacted his firm about possible legal action against Houlihan’s Restaurant after customers possibly were exposed to hepatitis A.
Marler said that early Tuesday afternoon, the family, whom did not identify, gave permission to file suit against the restaurant, adding, "It’s a family of four who, interestingly, were eating at the restaurant when the health department was there [Friday evening],” Marler said.
On Friday, representatives of Houlihan’s Restaurants Inc. told the Kane County Health Department about a worker who was diagnosed with hepatitis A, a disease that attacks the liver.

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Hepatitis A is one of five human hepatitis viruses (hepatitis A, B, C, D, and E) that primarily infect the liver and cause illness. An estimated 80,000 cases occur each year in the U.S., although much higher estimates have been proposed based on mathematical modeling of the past incidence of infection. Each year, an estimated 100 persons die as a result of acute liver failure in the U.S. due to hepatitis A, but the rate of infection has dramatically decreased since the hepatitis A vaccine was licensed and became available in the U.S. in 1995.

Hepatitis A is a communicable (or contagious) disease that spreads from person-to-person. It is spread almost exclusively through fecal-oral contact, generally from person-to-person, or via contaminated food or water. 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, although he or she is generally not ill at the time of food preparation. The peak time of infectivity, when the most virus is present in the stool of an infectious individual, is during the two weeks before illness begins. Although only a small percentage of hepatitis A infections is associated with foodborne transmission, foodborne outbreaks have been increasingly implicated as a significant source of hepatitis A infection.

Hepatitis A may also be spread by household contact among families or roommates, sexual contact, ingestion of contaminated water, ingestion of raw or undercooked fruits and vegetables or shellfish (like oysters), and from persons sharing illicit drugs. Children often have asymptomatic or unrecognized infections and can pass the virus through ordinary play to family members and other children and adults.

Symptoms of hepatitis A infection

Hepatitis A infection may cause no symptoms at all when it is contracted, especially in children. Such individuals will only know they were infected (and have become immune ñ you can only get hepatitis A once) by getting a blood test later in life. The incubation period (from exposure to onset of symptoms) is 15-50 days, with an average of 30 days. Many children and most adults will experience the sudden onset of flu-like symptoms. After a day or two of muscle aches, headache, anorexia (loss of appetite), abdominal discomfort, fever and malaise, jaundice (also termed icterus) sets in. Jaundice is a yellowing of the skin, eyes and mucous membranes that occurs because bile flows poorly through the liver and backs up into the blood. The urine will turn dark with bile and the stool will be light or clay-colored from lack of bile. When jaundice sets in, the initial symptoms begin to subside.

In general, the period of acute illness lasts from 10 days to three weeks, at which time affected individuals tend to recapture some sense of wellness. It is not unusual for blood tests to remain abnormal for six months (or more), prolonging recovery for up to a year. Most affected individuals show complete recovery within three to six months of the onset of illness. Relapse is possible, and although more common in children, it does occur with some regularity in adults.

Diagnosis and treatment of hepatitis A

There are blood tests widely available to accurately diagnose hepatitis A; blood samples are tested for hepatitis antibodies, which are present when the immune system responds to the hepatitis virus. Antibodies of the immune globulin (Ig) M variety, which indicate acute disease, and IgG antibodies, which stay positive for life, should both be measured.

Hepatitis A infection is an acute self-limiting disease. There is no specific treatment; treatment and management is merely supportive. The liver function tests generally improve as the affected individual begins to feel better. It is therefore well accepted that the need for rest is best determined by the person’s own perception of the severity of fatigue or malaise.

Preventing hepatitis A infection

Hepatitis A infection is totally preventable. Ill food-handlers should be excluded from work. Commercial food workers and other individuals who prepare food for others must always wash their hands with soap and water after using the bathroom, changing a diaper, and before preparing food. Cooking food to a temperature of 185∞F or higher will inactivate hepatitis A.

After a known exposure to hepatitis A, administration of a shot of immune globulin should be considered. If administered within two weeks of the exposure, it will usually be effective in preventing or at least ameliorating the disease.

Hepatitis A vaccine is the best protection from hepatitis A infection. The vaccine is recommended for persons traveling to areas with increased rates of hepatitis A, men who have sex with men, injecting and non-injecting drug users, persons with blood clotting factor disorders (such as hemophilia), persons with chronic liver disease, and children living in regions of the U.S. with increased rates of hepatitis A. The vaccine may also help protect household contacts of those with hepatitis A infection. Vaccination of food handlers would likely substantially diminish the incidence of hepatitis A outbreaks. The vaccine is licensed for individuals aged two and older, but there is good evidence that the vaccine is safe and effective at one year of age.

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The Food Safety Network, a partnership between the University of Guelph, in Guelph, Ontario, Canada, and Kansas State University, in Manhattan, Kansas, posted its most recent food safety infosheet recently.  This infosheet, as seen to the left, is on the topic of hepatitis A outbreaks.

Potential hepatitis A outbreaks have recently been reported in several states.  Infected food workers can transmit hepatitis A by practicing improper hygiene, and restaurant customers have been warned that they have been exposed to the hepatitis A virus and advised to receive Immune globulin shots to prevent infection with hepatitis A.  Preventive measures are only good for the two weeks after inital exposure to the virus.

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Hepatitis A found at Queen Creek restaurant

By The Associated Press

QUEEN CREEK -- Health officials say Hepatitis A has been discovered in a food handler working at a Subway restaurant in Queen Creek.

Pinal County health officials say they're investigating. They tell the Tribune that anyone who ate at the restaurant between Dec. 10 and dec. 23 may have been exposed to the virus.

Hepatitis A can lead to liver disease and should be treated immediately.

This latest case comes on the heels of a report that food handlers who worked at two Guadalupe restaurants had the virus and customers may have been exposed last month.

The virus can spread after an infected person fails to thoroughly wash their hands after using the restroom.

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Marler Clark client Richard Miller, who became ill with a hepatitis A infection after eating at a Chi-Chi's restaurant in 2003, was interviewed for a story that appeared today at MSNBC.com titled, "Restaurant industry battles wave of illness." An excerpt from the story follows:

"Three years ago, an ambulance rushed Richard Miller to the hospital, where he had an emergency liver transplant after contracting Hepatitis A from a special dinner platter at Chi-Chi’s restaurant in Beaver, Pa. So the recent food illness outbreaks at Taco Bell, Taco John’s and Olive Garden restaurants hit him hard.

'It’s sort of like, 'Oh no, not again,'' said Miller, 60. 'There needs to be more regulation of the food supply.'"

Miller's sentiments have been echoed recently by other food safety advocates, such as his attorney, Bill Marler, on his blog at www.marlerblog.com.

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What is the future for California grown? 

Commentary from Christine M. Bruhn

Advice to buy locally grown has new appeal as California is associated with recurring outbreaks. Restaurants selling tainted food also suffer. A restaurant chain in Pennsylvania went out of business as a result of a 2003 hepatitis A outbreak traced to green onions. Food service establishments don't want to be part of a food-borne illness story. The public and the food service industry want this to stop. So do growers.

But the Centers for Disease Control and Prevention indicate that the proportion of illness traced to fresh produce is increasing. Growers can expect more outbreaks in the future. This is because one in four Americans are at increased risk for food-borne disease. People are eating more fresh produce. Fresh produce does not undergo a pathogen "kill step." When eaten raw, any pathogen would still be viable. Health officials also have better reporting and surveillance techniques than in the past.

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Commentary from Lorraine Heller

A number of Democratic senators have called for the establishment of a joint task force to examine recent outbreaks of E.coli, and suggest legal changes designed to prevent future problems....

Produce has also been linked to previous foodborne disease outbreaks. In 2004, an outbreak of Hepatitis A was traced to lettuce and tomatoes in California. The outbreak made 14 people ill. In 2003, an outbreak of Hepatitis A in Pennsylvania was traced to green onions from a Chi-Chi's restaurant. The outbreak killed 4 people and sickened 600.

And although the FDA has issued voluntary food safety guidance to the produce industry over the years, these recent outbreaks indicate that this voluntary approach may be insufficient to protect the public, said the senators in their letter.  Full story

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The latest E. coli outbreak may be linked to green onions distributed by McLane Co.  Tainted green onions also caused the 2003 Hepatitis A outbreak at a Chi Chi's restaurant that killed four people.  Full Story

Green onions grown in Mexico caused a November 2003 hepatitis A outbreak that killed four people and sickened 556 others, who ate or worked at a now-closed Chi-Chi's Mexican Restaurant in Center, Beaver County.

McLane Co. is the sole distributor of all ingredients including cheese, meat and produce for Taco Bell restaurants in New Jersey, Pennsylvania, Delaware and New York's Long Island. A company representative said federal investigators planned to test green onions, regular onions, cilantro, tomatoes and lettuce from its southern New Jersey warehouse.

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Click here for more on the hepatitis A scare in Llyodminster from the CBC News:

Health warning issued for Lloydminster eatery November 30, 2006 CBC.CA News Public health officials are urging anyone who ate at a Lloydminster restaurant to contact their local health office for a hepatitis A vaccination.

A worker at the KC Steakhouse in Lloydminster has tested positive for hepatitis A.

"Given Lloydminster is on a well-travelled route, there may be people across Alberta who have eaten at the restaurant between Nov. 20 to Nov. 28," Dr. Karen Grimsrud, deputy provincial health officer for Alberta, said in a release Thursday.

"It's important that people contact public health as soon as possible for a vaccine as it can prevent the disease."

Lloydminster is on the Saskatchewan border, east of Edmonton.

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Click here for the full story from City News

Toronto Public Health confirmed at least 20 cases of Hepatitis A Sunday night, some of which are already in hospital at Etobicoke General.

The origin of some cases hasn't been confirmed, but the mother of one patient suggests her son may have gotten it from school.

"I understand he picked it up at the school because he does not go anywhere other than school and back home," DiMauro said.

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There has been a hepatitis A outbreak at an elementary school in Etobicoke, Ontario.  Full story from Charlene Close at 680 News

Toronto Public Health confirms an outbreak of 20 cases of Hepatitis A at an Etobicoke middle school.
The source of the outbreak at Elmbank Junior Middle Academy hasn't been determined.
However, a health official tells CP24 that the general public is safe.
"Right now, there's no risk for the greater public...right now we're seeing people get Hepatitis A who live in households of people who have had it and who have had close contact," she said.

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For more information, click here.

How long does hepatitis A vaccine protect you?
A recent review by an expert panel concluded that estimates of antibody persistence derived from kinetic models of antibody decline indicate that protective levels of anti-HAV could be present for at least 25 years in adults and at least 14-20 years in children.

When are persons protected after receiving hepatitis A vaccine?
Protection against hepatitis A begins four weeks after the first dose of hepatitis A vaccine.

Can hepatitis A vaccine be given after exposure to hepatitis A virus?
No, hepatitis A vaccine is not licensed for use after exposure to hepatitis A virus. In this situation, immune globulin should be used. 

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Toxic hepatitis has killed a dozen people in Russia since September 2006 after drinking vodka, or so they thought:

And in the northwestern city of Pskov, near the border with Estonia, at least 12 people died of toxic hepatitis and 134 remained hospitalized with the disease after drinking bad alcohol since mid-September, local health officials said.

'All those people were diagnosed for toxic hepatitis caused by some alcohol liquid,' Vladimir Ryabenchenko, head of the Pskov Health Committee's emergency department, told The Associated Press.

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Some students at Tillman Elementary will be required to get an immune globulin shot after the health department reported four cases of hepatitis a at the school:

"PALMETTO - The health department this evening reports that four people at Tillman Elementary School have had hepatitis A in recent months, and that some people at the school will be asked to get shots to prevent their contracting the disease.

In a news release at 5 p.m., the Manatee County Health Department said the four people, who were not identified, have recovered and are no longer infectious.

Hepatitis A, which can be spread by poor hygiene following a bowel movement, infects and can damage the liver."

Technorati Tags: Hepatitis A, Hepatitis A Vaccination

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The Clovis News Journal reported that there have only been two additional cases of Hepatitis A since the Texas Department of Health began offering free imune globulin shots to anyone who patronized the Sonic Drive-In where an employee tested positive for Hepatitis A.  For further information on the shot please contact the Texas Department of State Health Services at (806) 655-7151:

"More than 2,600 shots to prevent hepatitis A have been administered this week in Hereford, Texas, following the diagnosis of a Hereford Sonic Drive-In employee with the virus, according to officials.

The Texas Department of State Health Services began administering free shots Monday afternoon to anyone who patronized the Sonic Drive-In at 305 North 25 Mile Ave. between Oct. 1 and Oct. 13, according to Department spokesperson Doug McBride. "

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The Food Safety Network out of the University of Guelph and Kansas State University put out a new infosheet in response to the most recent hepatitis A scare.  The infosheet can be found at the FSNet Web site.

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The Amarillo News reported that free hepatitis A vaccinations will be offered by the Texas Department of Health for anyone who ate at the Sonic restaurant located at 305 N. 25 Mile Avenue:

An employee at a Hereford Sonic Drive-In who was diagnosed with hepatitis A has led the Texas Department of State Health Services to offer free vaccinations to anyone who may have patronized the restaurant from Oct. 1 to Oct. 13.

Technorati Tags: Hepatitis A Vaccination

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Here are some frequently asked questions about Hepatitis A from the CDC.

What is hepatitis A? Hepatitis A is a liver disease caused by hepatitis A virus.

How is hepatitis A virus transmitted? Hepatitis A virus is spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. This type of transmission is called "fecal-oral." For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed.

Most infections result from contact with a household member or sex partner who has hepatitis A. Casual contact, as in the usual office, factory, or school setting, does not spread the virus.

What are the signs and symptoms of hepatitis A? Persons with hepatitis A virus infection may not have any signs or symptoms of the disease. Older persons are more likely to have symptoms than children. If symptoms are present, they usually occur abruptly and may include fever, tiredness, loss of appetite, nausea, abdominal discomfort, dark urine, and jaundice (yellowing of the skin and eyes). Symptoms usually last less than 2 months; a few persons are ill for as long as 6 months. The average incubation period for hepatitis A is 28 days (range: 15–50 days).

Technorati Tags: Hepatitis A

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There has been an outbreak of hepatitis a in Hong Kong affecting 33 people to date:

Hong Kong health officials issued a warning on Thursday following a spate of poisoning cases suspected to have been caused by oysters. At least 33 people have developed symptoms of food poisoning over the last two weeks after eating raw oysters from four different food premises, said a Department of Health spokesman. The latest case was reported on October 10.

"

Technorati Tags: Hepatitis A, Raw Oysters

Hepatitis A Outbreak

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05.oct.06
Eurosurveillance (Volume 11, Issue 10)
M Kojouharova and Editorial Team
The complete document (including charts) is available at: http://www.eurosurveillance.org/ew/2006/061005.asp
Hepatitis A is the most common type of viral hepatitis in Bulgaria, and accounts for more than 75% of all cases of viral hepatitis. Bulgaria is a country with intermediate endemicity of hepatitis A viral (HAV) infection. Between 1984 and 2005, incidence has varied between 27 – 80 cases per 100 000 population during non-epidemic periods, but has reached 234 cases / 100 000 during epidemic periods. Since 1983, all acute cases of jaundice due to hepatitis A virus have been subject to mandatory notification in Bulgaria. Since 2005, the European Union case definition and case classification have been adopted.
Since the beginning of 2006, 4793 viral hepatitis cases have been reported in Bulgaria (1498 cases more than the same period in 2005, when a total of 3295 cases occurred) (Figure 1). The increase of viral hepatitis incidence in 2006 is related mainly to two hepatitis A outbreaks in the regions of Sofia and Plovdiv.
Continue Reading...

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05.oct.06
Russian News Room
http://www.russiannewsroom.com/send.aspx?id=5413
In the past 24 hours, 38 new cases of Hepatitis A have been registered in Nizhny Novgorod in central Russia, a local official said Wednesday.
According to the official, 1,517 people, including 222 children, have been hospitalized since the recent outbreak. About 50% of them have been discharged from hospitals for dispensary observation, but 687 people remain hospitalized.
The official said 66,474 people have been inoculated against the virus of the city's 1.5 million people.
The epidemic is believed to have been caused by a sewage system breakdown.

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29.sep.06
Puget Sound Business Journal (Seattle)
Clay Holtzman
For 13 years, Seattle attorney William Marler has made a name for himself as the E. coli lawyer. Food service companies, vendors and manufacturers fear him like bacteria fear penicillin. Marler was quoted as saying, "I hope so. We're really good at what we do."
The six-lawyer practice of Marler and Clark LLP specializes in suing producers and manufacturers accused of selling tainted food products. Its clients have received combined settlements and verdicts of more than $250 million. That includes the famous 1993 Jack in the Box E. coli case in Washington state.
Today Marler is tracking the nationwide outbreak of E. coli illnesses tied to bagged spinach. The outbreak has been linked to 183 illnesses in 26 states, according to The Wall Street Journal, including at least one death. Marler is representing 81 of those, including, he says, two deaths that have yet to be announced.
The Bremerton native, who graduated from Washington State University and earned his law degree from Seattle University, talked with the Puget Sound Business Journal at his office.
On how he got started specializing in food-borne illness litigation: It started in 1993 when the Jack in the Box case hit here in Seattle. It was a war zone and I wound up representing a lot of sick kids in that case. After the Jack in the Box case happened I really thought I would just become a trial lawyer again doing what I do. Then the Odwalla case happened which also was sort of focused here. Once that case ended I made a business decision to sort of focus on this type of litigation. I hired Bruce Clark from Karr Tuttle Campbell and Denis Stearns and we started Marler Clark (in 1998). Since then, our focus has been exclusively food-borne illness litigation.
Continue Reading...

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By MARILYNN MARCHIONE
THE ASSOCIATED PRESS

THE CALIFORNIAN/RICHARD GREEN VIA THE ASSOCIATED PRESS
Spinach is inspected at a farm near Castroville, Calif., on Friday. The consumer warning on most fresh spinach was lifted last week.

SAN FRANCISCO -- Despite the recent E. coli spinach outbreak, food may be safer now than at any other time in the past decade, with illness occurring at record-low rates, new federal statistics show.

Consumers get part of the credit, for handling food more safely at home, but experts say the biggest improvement came from better industry controls and inspections.

Continue Reading...

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Monday, October 02, 2006

SAN FRANCISCO — Despite the recent E. coli spinach outbreak, food may be safer now than at any other time in the last decade, with illness occurring at record-low rates, new federal statistics show.

Consumers get part of the credit, for handling food more safely at home, but experts say the biggest improvement came from better industry controls and inspections.

"The food is actually cleaner to begin with," said Dr. Robert Tauxe, top food scientist at the federal Centers for Disease Control and Prevention. Certain germs have dramatically declined, and "that to me is really solid progress."

However, the trend could reverse in coming years if fruit and vegetable growers do not address problems like those that led to the spinach scare, Tauxe and others said.

Continue Reading...

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Tue 26 Sep 2006

A total of 1324 hepatitis A cases were registered in the region of Plovdiv, Dnevnik newspaper reported.

The hepatitis cases in the city of Plovdiv were 933. The number increased by 17 only for a day.

The majority of the infected people lived in the Roma-populated neighbourhoods of Stolipinovo and Sheker mahala, Dnevnik said.

Some parents in Plovdiv refused to let their children to school as they had to study together with Roma students.

The Roma students, living in the potentially dangerous districts, were vaccinated against hepatitis on September 14, but the process of immunity building took two weeks, Dnevnik said.

Another four hepatitis cases were registered in the town of Karlovo. The number of hepatitis infections in the town reached 57, Dnevnik said.

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September 26, 2006
Citizen-Times

Over the past several years, Buncombe County has had several high-profile hepatitis A scares associated with local restaurants.

That makes it an economic as well as a health issue.

Hepatitis A scares do nothing to enhance the area’s appeal as a tourist destination and also discourage locals from eating out. The impact on restaurants can be devastating, as demonstrated a few weeks ago with the closing of Trevi Pasta Seafood & Pizza in Biltmore Forest following the discovery that one of the restaurant’s food service workers had the disease.

The question is: Why do there seem to be a larger number of such scares in our region and what can be done to reduce them?

Continue Reading...

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22.sep.06
Cape Breton Post
Parents are getting letters from a Sydney, Nova Scotia, elementary school advising them how to prevent the transmission of hepatitis A after one of its students and a family member tested positive for the virus.
Dr. Shelly Sarwal, the medical officer of health, said there is no need for panic but people should practise diligent hand-washing to prevent its spread while health professionals search for more cases.
Continue Reading...

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September 22, 2006
The Journal Gazette (Fort Wayne, IN)
http://www.fortwayne.com/mld/journalgazette/15579143.htm

A local Pizza Hut gave away “thousands” of pizzas in a promotional deal to remedy slumping sales in the aftermath of a hepatitis A diagnosis involving a server at the restaurant last month.
Coventry Pizza Hut, near Interstate 69 and U.S. 24, had a line extending into its parking lot and a parking lot overflowing with cars Thursday, said Dave Bobilya, chief financial officer for Pizza Hut of Fort Wayne Inc. That was the last day customers could use a coupon included with a letter of community appreciation that ran in a full-page ad in the Sept. 10 editions of The Journal Gazette.
“There’s just been so much demand,” said Bobilya, who declined to give specific sales figures. A medium one-topping pizza typically costs

Continue Reading...

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Wed, Sep. 20, 2006

The FDA's alarm is extreme, area farmers say, and threatens their harvest this month.
By Edward Colimore, Michael Klein and Dianna Marder
Inquirer Staff Writers

Farmer Jamie Graiff of Gloucester County surveys his crop of baby leaf spinach. Usually, he would sell 14,000 pounds a week. As the Food and Drug Administration urges consumers to avoid all fresh spinach - bagged, bunched, organic, and otherwise - local farmers say the FDA actions may be unnecessarily extreme.

Pennsylvania and New Jersey farmers are poised to harvest their crops as early as this week, but supermarkets in both state are not buying in the wake of a particularly nasty outbreak of E. coli contamination.

The grocery shelves have been stripped, and the restaurant associations in both states say spinach should be off the menu entirely for now.

Continue Reading...

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September 19, 2006

Ontario Inland Valley Bulletin (CA)

Joe Blackstock

POMONA -- Individuals who ate at a north Pomona restaurant in August are being urged by county officials to get tested for acute Hepatitis A if they suffer from symptoms of the disease.
Three patrons, who ate at the Senor Baja eatery at 320 E. Foothill Blvd. in August, were diagnosed in recent weeks with that disease, according to a press release from the Los Angeles County Department of Public Health.
The business remains open after the department's environmental health staff inspected it and found no source of potential infection for hepatitis. The restaurant's management is working with the county to find the source of the problem, according to the release.
The county said the incubation period of Hepatitis A is from two to seven weeks. As a result, patrons of the restaurant in August should be on the watch until Oct. 1 for symptoms that include jaundice (yellow eyes or skin), fever and chills accompanied abdominal pain or vomiting, and/or light-color stool or dark urine. The virus is spread close contact or fecal contamination of food or drink. The close contact can be through household or sexual partners. The press release indicated that people who have been vaccinated against hepatitis are not at risk of acquiring it.

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Sep 18, 2006

(CBS) POMONA, Calif. Three people who ate at a Pomona restaurant last month have been diagnosed with acute hepatitis A, the Los Angeles County Department of Public Health announced Monday.

Health officials are working with Senior Baja, located at 320 E. Foothill Blvd., to identify the source of the disease.

The restaurant remains open because a recent inspection by the Department of Public Health did not find an ongoing source of potential infection.

People who ate at Senor Baja in August and develop symptoms of hepatitis A before Oct. 1 -- including jaundice, fever, light colored stools or dark urine -- should contact their doctor.
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By MARIAN BURROS
September 16, 2006
The outbreak of E. coli O157:H7 linked to prepackaged fresh spinach is the latest in an increasing number of food-borne illnesses from fruits and vegetables.

Dr. David Acheson, chief medical officer for the Center for Food Safety and Applied Nutrition at the Food and Drug Administration, said the evidence so far suggested that those who became ill had eaten the spinach uncooked.

But the agency has issued a blanket warning, recommending that consumers throw out all prepackaged fresh spinach rather than cooking it because of the chance of cross-contamination. Health officials are concerned that, out of the package, the bacteria could contaminate other foods that are eaten raw.

Continue Reading...

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September 18, 2006
by Rebecca Prescott

Travelers visiting many tropical, sub-tropical and developing countries run an increased risk of suffering a gastrointestinal illness. These are usually caused by bacteria, parasites and viruses. The microscopic bugs at the top of these rather gut wrenching (for all the wrong reasons...) charts are E Coli, the staphylococci, shigella and salmonella species, campylobacter jejuni, cryptosporidiosis, and hepatitis A.
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September 15, 2006

SAMS GAP, NC — A farmer's contaminated spring is the suspected cause of a hepatitis A outbreak, in which four cases have been confirmed and 10 are under investigation, according to a September 15 story in the Citizen Times.

The farmer's crops that were watered with the spring water were burned and the owner will drill a new well, according to the story.

The farmer did not sell his produce and the cases have been limited to his friends and family, the story said.

Acting Health Director Jan Lounsbury said that area residents should not be worried about their groundwater, because this appears to be an isolated case, according to the article.

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12.sep.06
Journal of Food Protection (Volume 69, Number 9)
pp. 2217-2223(7)
Hewitt, Joanne1; Greening, Gail E.1
Abstract:
Quantitative real-time reverse transcription PCR (qRT-PCR) and cell culture (50% tissue culture infectious dose [TCID50]) were used to determine the effect of heat treatments on norovirus and hepatitis A virus (HAV) in the New Zealand Greenshell mussel (Perna canaliculus). Since it is common practice to cook mussels until the shells open, internal temperatures and opening times of mussels on boiling and steaming were determined at regular time intervals. Fifty mussels in batches of six were exposed to boiling and steaming. A mean internal temperature of 90°C (recommended for virus inactivation when maintained for 90 s) was reached after boiling for 170 s, with all 50 mussels open at 210 s. For steaming, the mean internal temperature achieved was only 83°C after 300 s, and all 50 mussels were open. When mussels were steamed for 180 s (mean internal temperature of 63°C), a significant 1.5-log decrease in the HAV titer (log TCID50) was observed. Following the immersion of mussels in boiling water for 180 s (mean internal temperature of 92°C), no viable HAV was detected. Continue Reading...

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by By Jordan Schrader, JSCHRADE@CITIZEN-TIMES.COM
September 15, 2006 

SAMS GAP- The one-story house at the center of a hepatitis A investigation spanning six states sits on U.S. 23 North, just before North Carolina gives way to Tennessee at Sams Gap.

Statement from a Madison County property owner. At least four cases of hepatitis A were found among guests who visited the property this summer. (26 KB)

A greenhouse, no taller and only slightly longer than the motor home parked nearby, indicates a modest garden rather than a farm.

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by Jordan Schrader, STAFF WRITER
September 14, 2006

MARSHALL – Officials have destroyed the crops grown at a Madison County farm where contaminated water led to hepatitis A cases throughout the country.

Public health officials have refused to identify the farm in northeastern Madison County. But they issued a statement from its owner late Wednesday apologizing to any county farmers who might lose customers afraid of eating their produce.

The farm grows vegetables only for its residents’ consumption, the unidentified man said in his handwritten note. None of this year’s crop was sold publicly.

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There’s too much bacteria – experts
By Sven Herselman
East London, South Africa
CONCENTRATIONS of hepatitis A-causing bacteria and faecal matter in the Buffalo River are at an unacceptable and dangerous level. This is according to the head of the Border Occupational Health and Environmental Services, Di Nicolay.

She warns that with the start of summer, and in particular the school rowing season, residents must be sure that they are inoculated against the diseases caused by such bacteria.

Nicolay was speaking after viewing a report compiled by a private company on the status of the Buffalo River. She said she was not authorised to reveal the company’s name, but urged people to be aware of the situation.

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10 more suspected; health officials refuse to identify property in investigation
by Dale Neal, DNEAL@CITIZEN-TIMES.COM
September 14, 2006

MARSHALL — Health officials suspect contaminated drinking water might have caused 14 cases of hepatitis A among guests visiting a Madison County property this summer.

Four Madison County residents were confirmed to have the liver disease, while 10 more cases are under investigation in North Carolina, South Carolina, Florida, New Jersey, Washington and Oregon.

People who work on the property or were guests there are suspected to have contracted hepatitis from contaminated drinking water, the Madison County Health Department said Wednesday.

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10 more suspected; health officials refuse to identify property in investigation
by Dale Neal, DNEAL@CITIZEN-TIMES.COM
September 14, 2006

MARSHALL — Health officials suspect contaminated drinking water might have caused 14 cases of hepatitis A among guests visiting a Madison County property this summer.

Four Madison County residents were confirmed to have the liver disease, while 10 more cases are under investigation in North Carolina, South Carolina, Florida, New Jersey, Washington and Oregon.

People who work on the property or were guests there are suspected to have contracted hepatitis from contaminated drinking water, the Madison County Health Department said Wednesday.

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by STAFF REPORTS
September 13, 2006
The Madison County Health Department has reported that four confirmed cases of hepatitis A have broken out in Madison County, with 10 more cases under investigation.

The 14 cases, possibly linked, are believed to have originated from a private farm in the county that sells and shares produce to the public, said Jan Lounsburry, Acting Director of the Madison County Health Department.

“I cannot give specifics about which farm, or where it is located until further into the investigation,” she said. “We don’t want people to panic… just be aware of the signs and symptoms and report them to their local health department or health care provider.”

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September 13, 2006
Citizen Times

MARSHALL (NC) – Health officials have linked cases of hepatitis A around the country to a Madison County farm.

Fourteen people who work on the farm or were guests there are suspected to have contracted the disease, the Madison County Health Department announced at a news conference today.

Officials would not identify the farm.

Hepatitis A has been confirmed in four Madison County residents, while 10 more cases are under investigation in North Carolina, South Carolina, Florida, New Jersey, Washington and Oregon.

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From 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 A. Approximately 30 - 50,000 cases occur yearly in the United States and the direct and indirect costs of these cases exceed $300 million. 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.  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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Bulgarian Parents Seek to Ban Hepatitis-Struck Kids from School

11 September 2006, Monday.

Parents from Bulgaria's second city of Plovdiv have turned to school headmasters asking them to close the school doors for kids from the city's Stolipinovo District, where hepatitis has been raging throughout the summer. Continue Reading...

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10 September 2006 | 08:40 | FOCUS News Agency

Sofia. There are 914 people infected with hepatitis “A” in Plovdiv region, the National Medical Coordination Center (NMCC) announced for FOCUS Agency. There are 663 people affected in the city of Plovdiv only and 479 of them live in Stolipinovo quarter and 68 in Sheker Mahala. The NMCC announced that the Regional Inspection on Prevention and Control of Public Health hasn’t announced for new cases in Svoge Municipality since 4th September.

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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. Persons traveling to countries where hepatitis A is common 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 from 12 months of age and older: Travelers to areas with increased rates of hepatitis A 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.
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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07.sep.06
Reuters

MILAN - The European Union's food safety agency EFSA was cited as saying on Wednesday it had found no "convincing evidence" of a link between an exotic juice and four reported cases of hepatitis in Austria and Germany.
Noni juice, made from the fruit of the Morinda Citrifolia plant, sometimes known as the Indian Mulberry, hit shelves across Europe after it was authorised by the European Commission in 2003 for the market.
Sold as a novel health drink, it had been promoted as a helping boost for the immune system.
In documents published on its Web site (www.efsa.europa.eu), EFSA said the European Commission had asked it for its opinion after Austria's health and food safety body sounded a warning in 2005 after three acute hepatitis cases were reported.
EFSA said its expert panel on dietetic products, nutrition and allergies examined the Austrian and Germany cases in which the people who consumed the juice later came down with hepatitis.
"The NDA Panel came to the conclusion that there is no convincing evidence for a causal relationship between the acute hepatitis observed in the case reports and the consumption of noni juice," EFSA said in a statement.

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Public health officials have identified three new cases of hepatitis A in the past week.

The cases are all in one family and connected to an earlier case, bringing to 15 the total number of infections in an outbreak in the Lower Sackville area. The first case was identified in early June.

Five of the initial 12 cases were students from Hillside Park Elementary School. None of the new cases are associated with the school, said Geoff Wilson, spokesman for the Capital district health authority.

Public health staff are following up with the contacts of the new cases. That may include vaccination against the virus when appropriate, he said.

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By Bill Collins
09/05/06
Staff Writer

Mid-August's hepatitis A scare in Fort Wayne has prompted local health concerns about the virus.

Several cases of the disease that were reported were apparently contracted from a Fort Wayne Pizza Hut employee. The employee was working between August 3 and 19, but has not been employed there since that time.

Hepatitis A can be transferred simply from an infected person not observing proper hygiene procedures, said Dr. Sarah Sayger of the Purdue University Student Health Center.

Sayger said people sometimes try to cut time and do not do a thorough job washing their hands and following proper health procedures in restaurants.

Although not washing thoroughly every time may have little consequences for most people, proper hygiene in this area is vitally important for those handling food. The signs in restaurant bathrooms stating that employees must wash hands before returning to work are meant to prevent this kind of outbreak.

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No other cases reported, but officials wary
By Michael Schroeder
The Journal Gazette

Since a server at the Coventry Pizza Hut was diagnosed with hepatitis A nearly two weeks ago, no related cases have been reported.

But health officials – fully aware of the virus’ average monthlong incubation period during which infected persons exhibit no outward symptoms – are keeping close watch.

In all, 3,858 people received shots at eight immunization clinics set up in the wake of the hepatitis A diagnosis Aug. 24, Dr. Deborah McMahan, Allen County health commissioner, said Tuesday.

A total of 219 doses were sent out of the area (though not all were used) to Purdue University, Indiana University, Notre Dame and even Canada, among other locations. The shots are intended mostly for students and some others who ate food from the Coventry Pizza Hut.

Working with the restaurant, the health department estimated that 5,000 to 10,000 people may have been exposed to hepatitis A between Aug. 3 and Aug. 19, when the infected server was working and contagious. A total of 5,100 meals were served during that time.

So health officials are reminding all those who dined in, carried out or ordered from Coventry Pizza Hut between Aug. 3 and Aug. 19 not to become complacent.

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David O'Brien
Record-Courier staff writer
9/6/2006

Three days after announcing a male student had contracted Hepatitis A and could potentially have passed the virus to others through his job preparing catered meals, Kent State Universitys chief physician said no further cases of the liver disease have been identified.

Dr. Ray Leone said University Health Services had immunized approximately 394 people out of the almost 500 thought to be most at risk for contracting the disease as of noon Tuesday. Between 40 and 50 doses of immune globulin were distributed Friday, more than 200 before 1 p.m. Saturday, and slightly more than 100 during Sunday and Monday.

A total of 380 people were immunized against the non-life-threatening disease by Monday evening. All those potentially affected have since been notified and most of those immunized.

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September 3, 2006
Akron Beacon Journal (OH)
Lisa A. Abraham
http://www.ohio.com/mld/ohio/news/nation/15431779.htm?source=syn

KENT - Kent State University officials are dealing with one confirmed and one suspected case of hepatitis A in students, and are working with public health officials to administer hundreds of immunizations to keep the virus from spreading.

The confirmed case is a male student who works for a branch of the school's food service that provides catering for university functions.

Officials at a news conference Saturday said they have begun tracking down about 500 people who may have come in contact with food the student helped to prepare, as well as his co-workers and roommates.

By Saturday afternoon, Kent's University Health Services had administered 270 shots of immune globulin -- hepatitis A antibodies, which can help to prevent the virus in people who have already been exposed.

Hepatitis is an inflammation of the liver caused by a virus and occurs in several forms. Hepatitis A is usually not life-threatening and has an incubation period of two to six weeks. Symptoms include fever and nausea.

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By Jennifer L. Boen jboen@News-sentinel.com

The ripple effects of possible exposure to hepatitis A by up to 10,000 Coventry Pizza Hut diners continue to be felt in the greater Fort Wayne area and beyond.

As the Fort Wayne-Allen County Department of Health continues immunizing people in mass clinics at Memorial Coliseum this week, anyone who gets the immune globulin, or Ig, shot to ward off the liver disease is now unable to be a blood donor for 12 months after the shot, American Red Cross officials announced Wednesday. In addition, anyone who dined at the restaurant between Aug. 12 and Aug. 19 but opted not to get an Ig shot is ineligible to give blood for four months.

The hepatitis A exposure stems from an employee at Pizza Hut, 5735 Coventry Lane, testing positive for the disease on Aug. 24. The individual served food and drink during that eight-day period, potentially exposing patrons to the virus. Ig must be given within 14 days of infection and does not provide long-term immunity to people who may subsequently be exposed to the hepatitis A virus.

The Pizza Hut employee has not worked at the restaurant since Aug. 19, and no cases of hepatitis A related to this employee have been detected. The health department has fully cleared the restaurant for operation.

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David O'Brien
September 3, 2006
Record-Courier staff writer

Kent State University officials and local health departments are taking preventive measures against the potential spread of the Hepatitis A virus after Fridays confirmation that a male student employed with University Dining Services had the virus.

Hepatitis is an inflammation of the liver caused by a virus. As of 1 p.m. Saturday, approximately 270 preventive immunizations had been performed by University Health Services on the unidentified male students roommates, coworkers and anyone who came into direct contact with him or ate more than two catered meals he may have prepared between Aug. 18 and Aug. 24, according to the university and local health officials.

The male student, who was involved in preparing as many as 500 catered meals in the Kent Student Center prior to being diagnosed, lives in off-campus housing and is now healthy, according to chief university physician Dr. Ray Leone.

Officials said a second possible case is unrelated. In that case, a female KSU student suspected of having Hepatitis A was hospitalized Friday at Robinson Memorial Hospital in Ravenna, unable to eat and suffering from dehydration.

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September 2, 2006
The Journal Gazette (IN)
Michael Schroeder
http://www.fortwayne.com/mld/journalgazette/15423857.htm

Gary Boyer, operations director at Wendy’s in Marion, still hears
comments about hepatitis A.

It’s been more than two years since it was reported that an employee
at the restaurant was diagnosed with the virus. No other workers or
patrons ever contracted the virus, and sales are healthy. But the
impression left by the episode – which prompted nearly 6,000 people to
receive immunization shots – lingers, he said.

So when news broke that a server was diagnosed with hepatitis A at the
Coventry Pizza Hut in Fort Wayne, Boyer’s heart went out to all those
working at the restaurant.

“Through no fault of their own, they are going to take a huge
financial hit,” Boyer said Friday. He was speaking from experience:
The initial effect of the 2004 hepatitis occurrence at his Wendy’s
“was dramatic and substantial,” he said. While Boyer didn’t disclose
specific figures, he said the fast-food restaurant’s sales have
rebounded.

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Hundreds get shots; state declares hep A outbreak
by Angie Newsome, ANEWSOME@CITIZEN-TIMES.COM
August 30, 2006

ASHEVILLE — As 250 restaurant goers lined up Tuesday at the Buncombe County Health Center for free immune globulin shots, state and local health officials investigated a mini outbreak of hepatitis A in Buncombe and Madison counties.

Medical Director Dr. Susan Mims said a total of four hepatitis A cases were confirmed in Buncombe County in August, adding to two others confirmed in April and July. Officials also recently confirmed two cases in Madison County.

On Tuesday, officials offered the first of two shot clinics organized after two cases were confirmed on Monday. Officials estimate that a sick employee exposed just more than 1,300 people who ate at Trevi Restaurant & Gourmet Market between Aug. 17 and Friday. They ask that those who ate there at that time go to the health center for free immune globulin shots, a serum that can prevent or help reduce symptoms of the illness if it is administered within two weeks of exposure. The second clinic was scheduled for today.

Symptoms include fever, chills, abdominal pain, nausea, vomiting, diarrhea, yellowing of the eyes and skin and dark urine. They appear about 30 days after exposure but can occur up to 50 days later.

“The state is calling this a small outbreak in a regional sense and trying to link this to other cases across the country,” Mims said.

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Each family needs to prepare now to have food, other essentials on hand.
By Jennifer L. Boen jboen@news-sentinel.com

What would you need to survive in your home for a week, maybe two or even a month? Allen County residents are encouraged to think on that and begin gearing up for a potential pandemic flu. Starting today, free pandemic flu preparedness guides are available at area grocery stores and pharmacies.

Committees organized by the Fort Wayne-Allen County Department of Health have been meeting for months to develop the guides, which include extensive checklists of recommended nonperishable grocery items, medical supplies and emergency equipment that individuals and families should have on hand.

States and counties have been mandated by federal health officials to prepare for a pandemic disease. The one most feared is the H5N1 avian flu virus, which has infected 241 people in Asia, Africa, the Middle East and Eastern Europe; 141 of those individuals died. No bird or human cases have been found in the United States to date.

Although so far this year only nine new human cases have been reported, the World Health Organization warns slight mutations in H5N1 could allow rapid human-to-human transmission, which has not yet occurred. The H5N1 avian flu strain abroad is similar to the one that caused the 1918 pandemic flu. Also disconcerting is the fact many of the cases of H5N1 that have occurred in the past year in China have occurred in areas with no reported outbreaks in poultry. The first cases in Asia occurred in individuals who had direct contact with infected birds.

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30.aug.06
Charleston Gazette (WV)

As a result of potential exposure by an infected staff member in one classroom, children and staff of the Kanawha County Schools Head Start Program, located at the Martin Luther King Center in Charleston, will be offered preventive treatment for hepatitis A.

Nurses from the Kanawha-Charleston Health Department will be on hand beginning 9 a.m. today to discuss the treatment with caregivers and to administer injections of hepatitis A immune globulin. No children or other staff members have reported being ill.

For more information, consult the Health Department’s Web site at www.kchdwv.com or call 348-1088.

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School opening worries parents
By JOHN GILLIS Health Reporter
August 30, 2006

No new cases of hepatitis A have been identified in the past week, public health officials announced Tuesday.

But with classes set to resume next week, some Lower Sackville parents are worried the virus could have a resurgence among children in the community.

Twelve people have been infected since an outbreak began in early June. Five of them are students at Hillside Park Elementary School.

Dr. Robert Strang, Nova Scotia’s medical officer of health, sent letters earlier this month to parents of children at the school describing the virus and its symptoms and urging them to alert public health about any potential cases.

Officials will be visiting each classroom at Hillside once school begins to teach children about proper handwashing, and more information will be sent home in registration kits. They’ll also give handwashing classes at nearby Sycamore Lane Elementary School.

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Lax vaccination requirements are no excuse for travelers to endanger hometowns.
News Sentinel
Wed, Aug. 30, 2006

For the second time in two years, travelers have come back home to Indiana and created public-health problems. How often does this need to happen before the United States requires its citizens to have a full slate of vaccinations before they receive passports? How many times do innocent neighbors need to risk serious illnesses before people who travel beyond the U.S. and Canada gather a clue and immunize themselves against every vaccine-preventable disease in circulation?

In 2005, an Indiana teenager went to Romania without vaccinations, contracted measles and, after she returned, spread them to more than 30 people in her community. Tracking down this girl’s contacts and containing the outbreak cost at least $160,000. Three of the measles patients were seriously ill and had to be hospitalized. One of them spent six days on a ventilator.

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County plans shots for recent Trevi customers
by Andre A. Rodriguez, ARODRIGUEZ@CITIZEN-TIMES.COM
August 29, 2006

ASHEVILLE — The Buncombe County Health Center on Monday confirmed a case of hepatitis A in restaurant worker, setting in motion plans to give up to 1,300 preventive shots to head off any chance of an outbreak.

The center urged that anyone who has eaten at Trevi Pasta Seafood & Pizza restaurant from Aug. 17 to Friday get an immune globulin shot. The shots will be offered free beginning today.

“Contacting these individuals is critical because immune globulin, a serum which can prevent or reduce symptoms of hepatitis A, must be given within two weeks after exposure,” Medical Director Dr. Susan Mims said.

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by Angie Newsome
August 29, 2006

ASHEVILLE - The Buncombe County Health Center will offer free shots to prevent an outbreak of hepatitis A from 3 p.m. to 7 p.m. today and Wednesday.

The shots are in response to two cases of hepatitis A health officials confirmed Monday. The cases add to the 45 cases Carol Schriber, spokeswoman with the N.C. Department of Health and Human Services, said have been confirmed in North Carolina this year as of June 30.

Beverly Levinson, health center spokesperson, said Tuesday that the cases two cases are thought to be unrelated.

One of the cases, found in a worker at the Biltmore Village restaurant Trevi Pasta Seafood & Pizza, prompted health officials to urge anyone who ate at the restaurant from Aug. 17 to 25, or last Friday, to get a Immune globulin shot. The serum can prevent or reduce symptoms of hepatitis A. Those vaccinated for helpatitis A do not need the shot, however.

Details on the second case are currently unknown.

To contact the health center, call 250-5203.

For more on this story, check back on CITIZEN-TIMES.com or read Wednesday’s Asheville Citizen-Times.

Contact Angie Newsome at 828-232-5856 or via e-mail at anewsome@ashevill.gannett.com.

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Citizen Times
by Staff reports
August 29, 2006

ASHEVILLE – Officials at the Buncombe County Health Center say they’ve given 190 shots of immune globulin to people as of 5:30 p.m. today to prevent the spread of hepatitis A after the virus was confirmed in two people, including one worker at the Biltmore Village restaurant Trevi Pasta Seafood & Pizza.

The health center urges anyone who ate at the restaurant between Aug. 17 and Aug. 25 to get the shot. Shots will be available from 3 p.m. to 7 p.m. Wednesday at the health department.

The health center also said that anyone who received a hepatitis A vaccine more than four weeks prior to this potential exposure does not need to receive a shot. Hepatitis A vaccine is given as a two-part series to prevent the illness. The second vaccine is given six months after the first.

People who ate at Trevi before Aug. 17 should be free from exposure to this case of hepatitis, according to the health center. Anyone who experiences symptoms of hepatitis A should contact their doctor. Symptoms can include fever, chills, abdominal pain, nausea, vomiting, diarrhea, jaundice (yellowing of the eyes and skin), and dark urine. Symptoms appear within 15 –50 days, usually within 30 days, of exposure.

The center has established a recorded hotline for hepatitis information. The hotline number is 250-6400 and it will be updated as needed.

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by Angie Newsome
August 29, 2006

ASHEVILLE - The Buncombe County Health Center will offer free shots to prevent an outbreak of hepatitis A from 3 p.m. to 7 p.m. today and Wednesday.

The shots are in response to two cases of hepatitis A health officials confirmed Monday. The cases add to the 45 cases Carol Schriber, spokeswoman with the N.C. Department of Health and Human Services, said have been confirmed in North Carolina this year as of June 30.

Beverly Levinson, health center spokesperson, said Tuesday that the cases two cases are thought to be unrelated.

One of the cases, found in a worker at the Biltmore Village restaurant Trevi Pasta Seafood & Pizza, prompted health officials to urge anyone who ate at the restaurant from Aug. 17 to 25, or last Friday, to get a Immune globulin shot. The serum can prevent or reduce symptoms of hepatitis A. Those vaccinated for helpatitis A do not need the shot, however.

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County plans shots for recent Trevi customers
by Andre A. Rodriguez, ARODRIGUEZ@CITIZEN-TIMES.COM
August 29, 2006

ASHEVILLE -- The Buncombe County Health Center on Monday confirmed a case of hepatitis A in restaurant worker, setting in motion plans to give up to 1,300 preventive shots to head off any chance of an outbreak.

The center urged that anyone who has eaten at Trevi Pasta Seafood & Pizza restaurant from Aug. 17 to Friday get an immune globulin shot. The shots will be offered free beginning today.

"Contacting these individuals is critical because immune globulin, a serum which can prevent or reduce symptoms of hepatitis A, must be given within two weeks after exposure," Medical Director Dr. Susan Mims said.

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28.aug.06
The Journal Gazette (Fort Wayne, Indiana)
Ashley Rhodebeck
http://www.fortwayne.com/mld/journalgazette/15380267.htm

More than 2,600 people crowded the Allen County Fairgrounds this weekend to receive treatment for hepatitis A after a local Pizza Hut employee was diagnosed with the disease Thursday.

Anyone who dined in, carried out or ordered food from the restaurant at 5735 Coventry Lane between Aug. 3 and Aug. 19 could have been exposed to the virus, which is rarely fatal, the Fort Wayne-Allen County Department of Health said.

The health department provided free shots this weekend for patrons who ate food from the restaurant between Aug. 12 and Aug. 19. Patrons who ate food from the restaurant before Aug. 12 will not benefit from the injection but should watch for symptoms and seek medical attention if symptoms develop, health officials said.

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26.aug.06
Fort Wayne News Sentinel (Indiana)/South Bend Tribune (Indiana)/ Associated Press

FORT WAYNE, Ind. -- County health officials were cited as saying Friday that thousands of patrons who dined at a local Pizza Hut between Aug. 3 and Aug. 19 may have been exposed to hepatitis A and a free clinic is scheduled this weekend at the Allen County Fairgrounds to administer shots to those at risk.
The Fort Wayne-Allen County Department of Health confirmed the case of hepatitis A in an employee who works at the Pizza Hut at 5735 Coventry Lane, near the Interstate 69 and U.S. 24 interchange. The employee was diagnosed with hepatitis A on Thursday, five days after last going to work.

The stories note that no other employees show symptoms, and no other cases so far have been identified.

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27.aug.06
WANE TV (Fort Wayne, Indiana)
http://www.wane.com/Global/story.asp?S=5331249

Roughly 1,150 people showed up for a Saturday shot clinic at the Allen County Fairgrounds, seeking protection after possible exposure to Hepatitis A.

The story says that most people at Saturday's shot clinic seemed to be taking it all in stride. Laura Aman, on her way out of the shot clinic, was quoted as saying, "I never got into a state of panic or anything, but it's certainly not something you want to hear about or think about."

Tyler Wells, on his way in to get a shot, was quoted as saying, "I didn't think much about it, because I didn't have any of the symptoms. I wasn't real concerned, but we're comin' to get the shots just in case."

Tia Tribby, who came to the clinic with her boyfriend, was quoted as saying, "Coming here calmed by nerves, just seeing everyone else in the same situation you are in."

The Health Department held a second shot clinic Sunday, from 9 a.m. to 3 p.m. For those who couldn't attend the weekend clinics, there will be a make-up clinic scheduled.

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By: HATC
2006-08-24

Three people infected with the hepatitis A virus have been rushed to Kaposv*r hospital, bringing the overall number treated against the disease to 16. All those affected live in Istv*ndi, Somogy county, where the epidemic broke out two weeks ago.

Tests show that a failure to observe hygiene may have caused the infection, which was contracted by residents of houses without electricity or running water.

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August 24, 2006

HUNDREDS of students were yesterday inoculated to prevent an outbreak of hepatitis A at their school after a tuckshop lady tested positive to the virus.

A mother who volunteered at St Patrick's College, Strathfield, on August 11 was diagnosed with the contagious disease on Monday.

The State Government has defended its decision to send out a media alert at 6pm on Tuesday -- more than 24 hours after the worker had been diagnosed.

"Public health officers began working with the school immediately to identify the possible risk to others and to put arrangements in place for the clinic," NSW Health communicable diseases director Dr Jeremy McAnulty said. "The media release was sent out to coincide with parents receiving notification."

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The Fairfax County Times
By: Kali Schumitz
08/22/2006
State legislators this year added to the list of vaccines that children are required to get in order to go to any school, preschool or daycare in the state.

The Fairfax County Health Department is offering free doses of the Tdap vaccine for rising sixth-graders at various locations through Sept. 23.

Visit www.fcps.edu/news/vaccine.htm or call 703-246-2411 for details.

The new rules are intended to follow recommendations of the Centers for Disease Control, according to the text of the code that went into effect July 1.

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By Katelyn John
August 23, 2006

HEALTH chiefs will investigate a Sydney school tuckshop as a program to inject 300 students to guard against an outbreak of hepatitis A began today.

More than 100 students and 15 adults at St Patrick's College, a private Catholic school in Strathfield, were given immunoglobulin antibody injections at a temporary clinic.

The clinic will open again tomorrow as part of the measures to protect 300 students believed to have eaten from the tuckshop on the day a hepatitis A-infected volunteer helped prepare food.

NSW Health communicable diseases director Jeremy McAnulty played down the threat of a hepatitis outbreak at the school, but said the department would investigate work practices at its tuckshop.

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22.aug.06
Yahoo News
http://au.news.yahoo.com/060822/2/108lf.html

About 300 students at a Sydney, Australia, school will be given preventative drugs after a tuck shop worker tested positive for hepatitis A.

NSW Health was cited as saying a clinic would be set up on Wednesday at St Patrick's College, a private Catholic school in Strathfield, which has students from Year 5 to 12.

The tuck shop worker, who prepared food for the students, did not display any symptoms at the time and was unaware they posed a risk to others, a NSW Health spokesman said.

Students who were potentially exposed to the virus will be offered preventative immunoglobulin antibody injections.

Letters were sent home to parents on Tuesday advising them of the situation and seeking permission to administer the antibody.

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The Chronicle Herald
August 22, 2006

Public health officials have discovered two new cases of hepatitis A connected to an outbreak in Lower Sackville.

That brings to 12 the number of people diagnosed with the virus since it first appeared in early June.

One of the cases reported Monday is a recent one connected to a person diagnosed earlier in the outbreak. The other was an older case identified as a result of letters sent to parents of students at Hillside Park Elementary School.

Symptoms of hepatitis A include diarrhea, dark urine, loss of appetite and light-coloured stool. It is passed in the stool and can be transmitted through hand contact when people don't wash their hands thoroughly after using the bathroom, changing a diaper or preparing food.

Infected people typically develop jaundice with yellowish eyes and skin. The virus usually passes in a few weeks.

No additional cases are suspected but officials say more cases are possible as part of the normal course of the virus.

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Aug 21, 2006
Canadian Press: ROSS MAROWITS

MONTREAL (CP) - A cocktail of bacteria, parasites and viruses in the water of Montreal's swimming pools has forced the city to close two-thirds of its outdoor facilities.

Mayor Gerald Tremblay asked mayors of the city's 19 boroughs to close 48 of the city's 73 outdoor pools following a media investigation. "Public health is important for our administration," Tremblay said Monday at a news conference. "We have to make sure that the safety our pools for our children and their parents is absolutely perfect."

Tests found high levels of E. coli, C. difficile, Legionella, Hepatitis A, and Giardia, which can cause various reactions, including diarrhea, nausea, eye and skin irritations and respiratory problems.

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The Chronicle Herald
August 16, 2006

Canada-A summer outbreak of hepatitis A in the Lower Sackville area seems to be in a lull.

The Capital district health authority said in a statement Tuesday that no new cases of the virus have been reported since Aug. 8 and no new suspected cases have been identified.

Public health personnel say they will continue to investigate the outbreak, because hepatitis A has an incubation period of 30 days and could reappear later in the summer.

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Evidence aside, parents face tough choices
By: Raheem Hosseini
Wednesday, August 16, 2006

The kids are finally back at school this week, but not without meeting the state's growing list of immunization requirements. But as the list grows, so does anecdotal concern over just how much medicine is too much.

"The problem is some of the fear out there is based on ... real dated information," said Cathy Dunbar, El Dorado County's immunization coordinator.

The reasons for parents' abstention varies, but one significant concern is borne from the much debated link between these vaccines and the spike in childhood autism cases.

Between 1987 and 2002, the number of individuals with full syndrome autism receiving services in California jumped 634 percent. That includes a staggering 97 percent increase between 1999 and 2002, when the state's autistic population went from 10,360 to 20,377, and doesn't include autism related disorders like Asperger's.

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August 15, 2006
Annie Kim
WREG TV

MEMPHIS, TN - The new school year means new teachers and new friends for students. But health officials are focused on developing healthy minds through good habits.

"Children going back to school are going to be exposed to colds, upper respiratory things," said School Health Supervisor Kathleen Johnston.

Five year old Ladvicus Sampson is starting Kindergarten this year. Jamie Sampson said she's making sure her son practices good hygiene.

"Make sure he keeps his face clean, his nails clean and his hands clean all of that," said Sampson.

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August 15, 2006

Newswise -- Educating your child's immune system is an important part of preventing disease and an important part of preparing for the upcoming school year.

Children can be immunized against a number of serious infectious diseases by receiving vaccines, said Andrew J. White, M.D., a pediatrician at Washington University School of Medicine and St. Louis Children's Hospital. Some vaccinations are given at birth and most are scheduled throughout early childhood, but important boosters should be given to school-age children.

"By following a regular schedule, and making sure a child is properly immunized, parents can ensure the best defense against dangerous childhood diseases, such as polio, measles and hepatitis," said White. "This protection is long-lasting, and will work this school year, next school year and into adulthood."

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Aug 15, 2006

WILMINGTON -- August is National Immunization Awareness Month. A lot of people don't like needles, but getting vaccinated is important to your health and disease prevention. That's the message from the New Hanover County Health Department.

The health department says they have some new vaccines and ways of helping you keep track of what you've been vaccinated against.

If you get your shots at the health department, they're registered with the North Carolina immunization registry. It's a computerized database that keeps track of all your shots.

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2006-08-14

NINETY-THREE teachers and students have been quarantined in a high school in the southern Guangxi Zhuang Autonomous Region after 69 students contracted acute hepatitis A, health officials said.

Fifty-six of the 69 students were still hospitalized yesterday. Yu Yang, deputy director of the Pingnan County Health Bureau, said Siwang Township reported 77 acute hepatitis A cases from July 21 to Wednesday, 69 of whom are students of the Siwang Township No. 2 High School.

As of yesterday, 13 of the 77 patients had recovered and been discharged from hospital.

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(Xinhua)
2006-08-13

NANNING -- Ninety-three teachers and students have been quarantined in a high school in south China's Guangxi Zhuang Autonomous Region, as 69 students of the school have contracted acute hepatitis A over the past 20 more days, local health official said on Sunday.

At press time, 56 of the 69 students are still hospitalized.

Yu Yang, deputy director of the Pingnan County Health Bureau, said Siwang Township reported 77 acute hepatitis A cases from July 21 to August 9, 69 of whom are students of the Siwang Township No. 2 High School. As of Sunday, 13 of the 77 patients have recoverd and been discharged from hospital.

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CP Health News
August 10, 2006

LOWER SACKVILLE, N.S. (CP) - Three more people have been diagnosed with hepatitis A - a temporary, flu-like illness - following an outbreak in a community outside Halifax.

That brings to 10 the number of confirmed cases of the virus in Lower Sackville, N.S.

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Aug 9, 2006
Canadian Press

LOWER SACKVILLE, N.S. (CP) - Three more people have been diagnosed with hepatitis A - a temporary, flu-like illness - following an outbreak in a community outside Halifax.

That brings to 10 the number of confirmed cases of the virus in Lower Sackville, N.S.

In mid-July, dozens of people began experiencing flu-like symptoms.

Public health officials said last month they had traced the infection back to a community barbecue in mid-June.

But Geoff Wilson, a spokesman for the Capital Health District, said Tuesday other potential sources are being considered as well.

He said they're attempting to trace the whereabouts of each infected person.

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The Chronicle Herald
Halifax, Nova Scotia
August 9, 2006

Three more people in Lower Sackville have been found to be infected with hepatitis A, public health officials announced Tuesday.

These cases are connected to a local outbreak that began in early June. Last week, the Capital district health authority said seven cases had been identified at that point.

No new cases are suspected, but surveillance will continue for some time.

One infected person was a student at Hillside Park Elementary School, and another works at Rock Church.

Public health staff have now vaccinated 75 family members, friends and close associates of the 10 confirmed cases.

Hepatitis A is passed in the stool and can be transmitted through hand contact when people don't properly wash after using the bathroom or changing a diaper and before preparing food. Its flu-like symptoms include diarrhea and loss of appetite, dark urine and light-coloured stool. Infected people typically develop jaundice with yellowy eyes and skin. The virus usually passes in a few weeks.

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August 9, 2006
Journal Pioneer (Summerside)
CP

Three more people have been diagnosed with hepatitis A following an
outbreak in a community outside of Halifax.

That brings to 10 the number of confirmed cases of the virus in Lower
Sackville, N.S.

In mid-July dozens of people began experiencing flu-like symptoms.
Public health officials said last month they had traced the infection
back to a community barbecue in mid-June.

But Geoff Wilson, a spokesman for the Capital Health District, said
Tuesday other potential sources are being considered as well.

He says they're attempting to trace the whereabouts of each infected person.
Dr. Shelly Sarwal, medical officer of health, said last month that the
first case was spotted in early June.

More than 75 people who have had close contact with that person and
others who have fallen ill have been vaccinated against the liver
disease.

It takes about 30 days for an exposed person to become sick and that
person can pass on the virus about two weeks before, and one week
after, becoming ill.

Hepatitis A is passed in the stool and can be transmitted through hand
contact when people don't properly wash after using the bathroom or
changing a diaper and before preparing food.

There is no treatment for hepatitis A.

Its flu-like symptoms include diarrhea and loss of appetite, dark
urine and light-coloured stool. Infected people typically develop
jaundice with yellowy eyes and skin.

The virus usually passes in a few weeks. Unlike hep B and C,
transmitted through blood and body fluids, it does not lead to
lifelong infection.

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by Angie Newsome
ANEWSOME@CITIZEN-TIMES.COM
August 8, 2006

ASHEVILLE -- Lice. Colds. Ringworm. Ah, to be a kid in school.

Getting sick at school is a rite of passage, like learning to write or do algebra. Just take a look at the chart above, which includes everything from mumps to meningitis.

But there are some things you can do to keep diseases at bay as the school year gears up. Last year, a whooping cough outbreak spread throughout the county, more than 50 cases.

The top piece of advice from Dr. Susan Mims, medical director at the Buncombe County Health Center? Wash your hands.

"I can't emphasize enough that with all the immunizations and all the things we offer that probably the most effective way to prevent the spread everything on the list is good hand washing," she said. "We need to teach them to wash their hands and model that for them."

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August 4, 2006
The Daily News (Halifax)

Jennifer Taplin Nurse Christine Johnson's face glows. Yesterday, she showed kids the danger of germs with simulated Glo Germ. The powder looks invisible to the naked eye, but under a black light, it glows.

"It shows children how easily germs are transmitted," said Johnson, after the group of kids left.

At a hepatitis A information open house at Rock Church in Sackville yesterday, Johnson put a little Glo Germ on her hand and then shook another person's hand.

The black light shows how easy it is to share germs. Johnson said she forgot sometimes about the powder on her hand and often touched her face.

These information sessions are in response to an outbreak of hepatitis A. Seven cases of hepatitis A were reported in Lower Sackville by Capital Health this week.

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04.aug.06
Canada News-Wire
Paul Callanan, Director of Environmental Health, Region of Peel

Brampton -- Peel Public Health has identified a case of Hepatitis A in an employee from the Tim Horton's restaurant at 2 Intermodal Drive in Brampton. Any customer at this location from July 8 to July 21, 2006 has a low risk of exposure to Hepatitis A.

"The risk of transmission in this case is low. At this point in time, we are not recommending vaccination of customers who might have been exposed.

However, as a precaution, we are advising customers who visited this Tim Horton's location between July 8 and 21 to monitor themselves for signs and symptoms of Hepatitis A," said Dr. Eileen De Villa, Associate Medical Officer of Health for the Region of Peel.

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Express News Service

Rajkot, August, 3: As many as 18 cases of Hepatitis A were reported in the city on Thursday. An investigation by the health department of Rajkot Municipal Corporation revealed that the drinking water supply had been contaminated following seepage of sewage water into pipeline.

ëëA total of 18 cases of Hepatitis A were reported from Gandhi Vasahat Society in Ward 5 on Morbi Road. The cases were detected during a survey by a team of health officials,'' said RMC Health Officer Pankaj Rathod. He ruled out the possibility of other such cases from nearby areas.

A person suffering from Hepatitis A has symptoms of fever, malaise, nausea, anorexia and abdominal discomfort -- all these due to inflammation in the liver.

On Wednesday, a delegation from the ward, led by councillor Anil Makawan, had made a complaint about some people having such symptoms. On Thursday, the health team conducted the survey and detected the cases.

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Wednesday, August 2, 2006
CBC News

Health officials have confirmed seven cases of hepatitis A in Lower Sackville, a community north of Halifax.

The hepatitis A virus, which attacks the liver, is spread when a person puts something in his mouth that has been contaminated by the feces of someone infected.

Usually, it's passed by someone with hepatitis A who uses the toilet but doesn't wash his hands before touching food.

Symptoms may include fever, nausea, dark urine and jaundice, and usually pass within a few weeks. The virus is most serious in the elderly or those who have weakened immune systems.

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