Hepatitis A Information

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

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

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

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

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

Another Hepatitis A case is being reported by a person who ate at the same restaurant in Hamilton Township.

Robbinsville Township health officials say the resident ate at Rosa’s Restaurant on 3442 South Broad Street during the time when a food handler reported having Hepatitis A.

The patient works in Hamilton Township. However, health officials say coworkers at the job only have a negligible risk.

The first case of Hepatitis A was confirmed last month in a worker at Rosa’s. In light of that, the township hosted a vaccination clinic at a local firehouse.

Then last week health officials announced two additional cases – a 53-year-old hair dresser and a 60-year-old part-time fitness instructor.

Both women reportedly thought they had the flu before they were diagnosed with Hepatitis A.

All three patients ate at Rosa’s in November while the employee worked there, but health officials say they can’t definitively link the new cases to the first.

Hepatitis A is spread through oral fecal transmission. It’s rarely fatal, but it is highly contagious, and symptoms can appear 2 to 6 weeks after exposure.

Tortilla Marissa’s, a Mexican restaurant in Fort Collins, CO, will not reopen until August 9 because of the Hepatitis A scare that the restaurant faced at the end of June, according to the Coloradoan.

The Larimer County Health Department has advised the owners to keep the restaurant closed that long due to the virus’ relatively long incubation period, which averages 28 days but can last up to 50 days in some cases.

The restaurant originally closed on June 27, a day after an employee tested positive for the virus, which has a high risk of being spread when an infected person handles food. In total, the restaurant will be closed 43 days.

The only way the owners could legally open before that would be to hire an entirely new staff.

The county health department administered roughly 800 vaccines to restaurant patrons following the incident, but many did not opt to receive a vaccine. No other cases of Hepatitis A have been reported in connection to Tortilla Marissa’s.

The restaurant received an “inadequate” rating after an inspection in late May, a month before the incident. In two follow-up inspections, the restaurant earned “good” and “excellent” ratings.

The owners say that the closure time will allow them to address the remaining concerns presented by the inspections.

Customers who ate chopped, ready-to-eat fruit from Westside Market at 2589 Broadway between August 9 and August 22 may have been exposed to hepatitis A, according to New York City Health Department officials. A food handler at Westside Market reported a case of Hepatitis A, and now customers of the market are urged to get a vaccination as a precaution.

The disease is spread by eating food that has been contaminated with traces of fecal matter from an infected person.

The fruits, which included watermelon, pineapples and coconut, were sold in plastic containers. Fruits involved include those packaged in plastic containers and sold in the refrigerated case immediately to the left as you enter the store and includes watermelon cut into halves and quarters; peeled whole pineapples; and shelled and cut coconut.

People can visit their regular doctor to receive this shot.

The Health Department will offer free hepatitis A vaccinations starting Friday at MS 258: Community Action School located at 154 West 93rdStreet New York, NY 10025 at the following times:

Friday, August 23: 2pm -8pm

Saturday, August 24: 10am -2pm

Sunday, August 25: 2pm -6pm

Monday, August 26: 2pm-8pm

(Those with insurance, please bring your insurance card with you)

People who were exposed but have already received two doses of hepatitis A vaccine sometime in their life do not need another shot; all others should be vaccinated.

Pregnant women are urged to consult with their doctor to discuss whether to receive vaccine or a different preventive treatment.

A food worker at the Ancestor Square Pizza Factory in St. George, Utah, has tested positive for hepatitis A infection.

The Southwest Utah Public Health Department hopes to identify customers who ate at the restaurant during the following times:

  • July 19 (Fri.):   6-9:30 p.m.
  • July 20 (Sat.):  6-9:30 p.m.
  • July 23 (Tue.): 5-9:00 p.m.
  • July 26 (Fri.):   6-9:30 p.m.
  • July 27 (Sat.):  5-9:30 p.m.

Those who ate during these times may have been exposed to hepatitis A and are advised to contact the health department to possibly receive a hepatitis A vaccination. Those who ate at the restaurant outside of these times and those who have already been vaccinated for hepatitis A do not need to seek treatment.

155 people have been confirmed to have become ill from hepatitis A after eating ‘Townsend Farms Organic Antioxidant Blend’ in 9 states: Arizona (23), California (76), Colorado (27), Hawaii (8), New Hampshire (1), New Mexico (9), Nevada (6), Utah (3), and Wisconsin (2). [Note: The cases reported from Wisconsin resulted from exposure to the product in California, and the cases reported from New Hampshire reported fruit exposure during travel to Nevada.]

86 (55%) ill people are women.

Ages range from 1 – 84 years.

87 (56%) of those ill were between 40 – 64 years of age.

11 children age 18 or under were also ill. None were previously vaccinated.

Illness onset dates range from 3/31/2013 – 7/14/2013.

67 (43%) ill people (all over 18 years of age) have been hospitalized, and no deaths have been reported.

Hepatitis A:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food.  The law firm has brought Hepatitis A lawsuits against such companies as Subway, McDonald’s, Chipotle, Quiznos, Chi-Chi’s and Carl’s Jr.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

As of July 17, 2013, 149 people have been confirmed to have become ill from hepatitis A after eating ‘Townsend Farms Organic Antioxidant Blend’ in 8 states: Arizona (22), California (73), Colorado (27), Hawaii (8), New Mexico (8), Nevada (6), Utah (3), and Wisconsin (2). [Note: The cases reported from Wisconsin resulted from exposure to the product in California.]

83 (56%) ill people are women

Ages range from 1 – 84 years;

85 (57%) of those ill were between 40 – 64 years of age.

10 children age 18 or under were also ill. None were previously vaccinated.

Illness onset dates range from 3/31/2013 – 7/5/2013

65 (44%) ill people (all over 18 years of age) have been hospitalized, and no deaths have been reported

Scenic Fruit Company of Gresham, Oregon today announced it is voluntarily recalling 5,091 cases (61,092 eight ounce bags) of Woodstock Frozen Organic Pomegranate Kernels. Based on an ongoing epidemiological and traceback investigation by the Food and Drug Administration (FDA) and the Centers for Disease Control (CDC) of an illness outbreak, the kernels have the potential to be contaminated with Hepatitis A virus.

No illnesses are currently associated with Woodstock Frozen Organic Pomegranate Kernels and product testing to date shows no presence of Hepatitis A virus in Woodstock Frozen Organic Pomegranate Kernels. The company’s decision to voluntarily recall products is made from an abundance of caution in response to an ongoing outbreak investigation by the FDA and CDC. The organic pomegranates are imported from Turkey.

Products were shipped from February 2013 through May 2013 to UNFI distribution centers in California, Colorado, Connecticut, Florida, Georgia, Indiana, Iowa, New Hampshire, Pennsylvania, Rhode Island, Texas, and Washington State. UNFI distribution centers may have further distributed products to retail stores in other states.

Woodstock Organic Pomegranate Kernels are sold in eight-ounce (227 gram) resealable plastic pouches (see image) with UPC Code 0 42563 01628 9. Specific coding information to identify the product can be found on the back portion of these pouches below the zip-lock seal. The following lots are subject to this recall:

C 0129 (A,B, or C) 035 with a best by date of 02/04/2015

C 0388 (A,B, or C) 087 with a best by date of 03/28/2015

C 0490 (A,B, or C) 109 with a best by date of 04/19/2015

On June 3, 2013, Townsend Farms, Inc. of Fairview, Oregon voluntarily recalled certain lots of its frozen Organic Antioxidant Blendbecause it has the potential to be contaminated with hepatitis A virus.

Preliminary laboratory studies of specimens from two states suggest the outbreak strain of hepatitis A virus (HAV) is genotype 1B. This strain is rarely seen in the Americas but circulates in the North Africa and Middle East regions.

This genotype was identified in a 2013 outbreak in Europe linked to frozen berries and another 2012 outbreak in British Columbia related to a frozen berry blend with pomegranate seeds from Egypt. The strain of 1B in the current outbreak does not match the European or Canadian outbreaks, however.

According to the label, the “Townsend Farms Organic Antioxidant Blend” frozen berry and pomegranate mix associated with illness contained products originating from the U.S., Argentina, Chile, and Turkey.

The CDC reported today that as of June 7, 2013, 79 people with acute hepatitis A infections that may be linked with consumption of a contaminated product have been reported by seven states: Arizona, California Colorado, Hawaii, Nevada, New Mexico, Utah, and Washington. These numbers are expected to change as the investigation continues.

The Colorado Department of Public Health and Environment (CDPHE) is working with the Centers for Disease Control, Food and Drug Administration and other health departments including Eagle County Public Health to investigate an outbreak of hepatitis A believed to be associated with frozen mixed berries purchased from Costco.

Townsend Farms Organic Antioxidant Blend frozen berries purchased from Costco appear to be the source of the outbreak. This blend includes cherries, blueberries, pomegranate seeds, raspberries and strawberries. Costco has removed this product from its shelves, although a formal recall has not been issued. The CDPHE is advising people to check their freezers and dispose of the product if found.

Approximately 30 cases of hepatitis A have been reported from five states, including Colorado, New Mexico, Nevada, Arizona and California. The first people became ill on April 29 and the most recent on May 21.

Five of the cases are Colorado residents, including one in Eagle County. Three women and two men have become ill. The other Colorado cases reside in Adams, Boulder, Clear Creek and Jefferson counties and range in age from 35 to 71 years. The number of cases in the outbreak may change, because on average it takes 30 days to become ill with hepatitis A after eating contaminated food.

The risk of contracting hepatitis A from eating these berries is low. However, those who have eaten Townsend Farms Organic Antioxidant Blend frozen berries during the past 14 days should contact their medical provider or pharmacist. The hepatitis A vaccine can prevent infection if given within 14 days of exposure. Some people should receive immune globulin instead of the hepatitis A vaccine. People who have consumed the berries should discuss with their doctor whether they should receive the vaccine or immune globulin.

Starting Monday, June 3, Eagle County Public Health will offer the hepatitis A vaccine at its Avon and Eagle locations at 100 W. Beaver Creek Blvd. Suite107 and at 551 Broadway, respectively. The offices are open from 8 a.m. to 5 p.m. and walk-ins are welcome; no appointment is necessary. Those who have received hepatitis A vaccine in the past do not need to be revaccinated.

If it has been more than 14 days since the berries were consumed, the vaccine won’t be effective preventing infection. People who ate the berries more than 14 days ago should monitor for symptoms and contact their physician if they become ill.

Early signs of hepatitis A appear two to six weeks after exposure. Symptoms commonly include mild fever, loss of appetite, nausea, vomiting, diarrhea, fatigue, pain in the upper right side of the abdomen, dark urine and jaundice (yellow eyes or skin). It is very important for those experiencing these symptoms not to go to work, especially those who work in food service, health care or child care.

The disease varies in severity, with mild cases lasting two weeks or less and more severe cases lasting four to six weeks or longer. Hepatitis A infection can be severe and can result in hospitalization. Some individuals, especially children, may not develop jaundice and may have an illness so mild it can go unnoticed. However, even mildly ill people can be highly infectious. People with symptoms suggestive of hepatitis should consult a physician immediately, even if symptoms are mild.

Hepatitis A virus is spread as a result of fecal contamination (fecal-oral route) and may be spread from person to person through close contact or through food handling. The virus is commonly spread by contaminated food or beverages. People are at increased risk of acquiring hepatitis A when they have been in close contact with an infected person.

The FDA is further investigating the product, including testing berries for the hepatitis A virus. The investigation may take several weeks to complete.