Header graphic for print

Hepatitis Blog

Surveillance & Analysis on Hepatitis News & Outbreaks

Cup & Saucer Cafes tied to Hepatitis A concern

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

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

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

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

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

Hepatitis A Grows in Michigan

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

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

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

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

Hepatitis A vaccination is recommended for:

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

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

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

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

Hepatitis A case prompts public health alert in Clearwater area

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

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

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

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

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

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

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

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

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

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

Dr. Helmcken Memorial Hospital in Clearwater:

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

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

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

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

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

Hepatitis A Outbreak in Hawaii Hits 292

In its weekly update Wednesday, the Hawaii Department of Health reported no new confirmed cases from Nov. 3 through 9. It recorded one new case the previous week, bringing the total number of sick people to 292. About a fourth of the outbreak victims have had symptoms so severe that they required hospitalization. At least one death, a 68-year-old woman, is attributed to the outbreak that was traced to frozen scallops imported from the Philippines and served raw by the Genki Sushi fast food chain. Another outbreak victim died, but was terminally ill and in hospice care so health officials are not attributing that death to Hepatitis A. All but 18 of the victims have been residents of Oahu. Seven victims are visitors who have returned to the mainland or overseas. Eleven outbreak victims live on the islands of Hawaii, Kauai or Maui. Only Genki Sushi locations on Oahu and Kauai served the implicated scallops.

Hawaii Sushi Hepatitis A Update

Since the last update, HDOH has identified 2 new cases of hepatitis A. Seventy-three (73) have required hospitalization.

Findings of the investigation suggest that the source of the outbreak is focused on Oahu. Eleven (11) individuals are residents of the islands of Hawaii, Kauai, or Maui, and seven visitors have returned to the mainland or overseas.

Although the 50-day maximum incubation period from the date of the scallops embargo has passed, HDOH continues to be alert for people who have had onset of illness earlier but may present late to a clinician, as well as possible secondary cases. Secondary cases have been rare in this outbreak and have been limited to household members of cases or close contacts of cases.

CONFIRMED CASES OF HEPATITIS A – 291
Onset of illness has ranged between 6/12/16 – 10/9/16.

Hepatitis A in Chehalis Washington

Lewis County Public Health & Social Services announced today that recent customers of the Shop’N Kart bakery in Chehalis, may have been exposed to hepatitis A.

“On October 6, 2016, a case of hepatitis A in a bakery worker was reported to the Health Department,” said Danette York, Lewis County Public Health & Social Services director. “To prevent illness, persons who have not been vaccinated against hepatitis A and ate decorated cakes or cupcakes from the bakery between September 22 and October 6, 2016 should contact their healthcare provider about treatment to prevent hepatitis A,” said York.

Persons who ate these foods between September 8 and 22 may also have been exposed, but it is now too late for treatment to prevent illness. If you ate decorated cakes or cupcakes from the bakery and develop symptoms of hepatitis A, contact your healthcare provider.

Shop’N Kart contacted public health as soon as they became aware of the infection and have taken every precaution to ensure the safety of their customers. No cases of hepatitis A associated with the bakery have been reported.

Hepatitis A is a viral disease of the liver. It is spread from person to person by the fecal-oral route, often by inadequate handwashing after using the toilet or changing diapers. Typical symptoms of hepatitis A include fatigue, fever, loss of appetite, abdominal pain, nausea, vomiting, diarrhea, and jaundice (yellowing of the skin or eyes). Symptoms usually develop 2–7 weeks after exposure. Some infections may be very mild or may not produce symptoms.

Hawaii Scallop Hepatitis A Outbreak Hits 271

As of September 14, 2016:

Since the last update, HDOH has identified 19 new cases of hepatitis A.  All cases have been in adults, 68 have required hospitalization.

Findings of the investigation suggest that the source of the outbreak is focused on Oahu. Ten (10) individuals are residents of the islands of Hawaii, Kauai, or Maui, and four visitors have returned to the mainland.

CONFIRMED CASES OF HEPATITIS A – 271
Onset of illness has ranged between 6/12/16 – 9/4/16.

An employee of the following food service business(es) has been diagnosed with hepatitis A. This list does not indicate these businesses are sources of this outbreak; at this time, no infections have been linked to exposure to these businesses. The likelihood that patrons of these businesses will become infected is very low. However, persons who have consumed food or drink products from these businesses during the identified dates of service should contact their healthcare provider for advice and possible preventive care.

Listed businesses will be removed from this list once 50 days have elapsed from the affected employee’s last service date while potentially infectious. Since the incubation period for hepatitis A is between 15 and 50 days, any customers who were potentially exposed at that business are no longer considered at risk for developing hepatitis A from that exposure after 50 days have passed.

  • Chili’s, Oahu, Kapolei (590 Farrington Highway), July 10, 12, 14, 15, 17, 18, 20, 21, 22, 23, 25, 26, and 27, 2016
  • Hokkaido Ramen Santouka, Oahu, Honolulu (801 Kaheka Street), July 21-23, 26-30, and August 2-6, 9-11, 2016
  • Papa John’s Waipahu, Oahu, Waipahu (94-1021 Waipahu Street), July 23-24, and August 2, 2016
  • New Lin Fong bakery, Oahu, Chinatown (1132 Maunakea Street), July 20, 22-23, 25, 27, 29-30, and August 1, 3, and 5-6, 2016
  • Hawaiian Airlines, July 31-August 1, August 10-12
  • Zippy’s Restaurant, Oahu, Kapolei (950 Kamokila Boulevard), August 14, 18–19, 21, 23, and 25–26
  • Harbor Restaurant at Pier 38, Oahu, Honolulu (1133 North Nimitz Highway), August 26 through September 12
  • Benjamin Parker Elementary School, Oahu, August 28 through August 30

123 with Hepatitis A in Arkansas, Maryland, New York, North Carolina, Oregon, Virginia, Wisconsin and West Virginia

Arkansas, Maryland, New York, North Carolina, Oregon, Virginia, Wisconsin, West Virginia and CDC, and the U.S. Food and Drug Administration (FDA) are continuing to investigate a multistate outbreak of foodborne hepatitis A. Information available at this time does not indicate an ongoing risk of acquiring hepatitis A virus infection at Tropical Smoothie Café’s, as the contaminated food product has been removed as of August 8. Symptoms of hepatitis A virus infection can take up to 50 days to appear.

As a result, CDC continues to identify cases of hepatitis A related to the initial contaminated product. As of September 14, 2016:

123 people with hepatitis A have been reported from eight states: Arkansas (1), Maryland (12), New York (3), North Carolina (1), Oregon (1), Virginia (98), West Virginia (6), and Wisconsin (1).

47 ill people have been hospitalized. No deaths have been reported.

Epidemiologic and traceback evidence indicate frozen strawberries imported from Egypt are the likely source of this outbreak.

Hawaii Hepatitis A Outbreak Update

The Source:

The Hawaii Department of Health (HDOH) is investigating an outbreak of hepatitis A in its state. For the latest case count and investigation findings, visit the HDOH outbreak investigation website. On August 15, 2016, HDOH identified raw scallops served at Genki Sushi restaurants on the islands of Oahu and Kauai as a likely source of the ongoing outbreak.

On August 18, 2016, Sea Port Products Corp. recalled three lots of frozen bay scallops produced on November 23-24, 2015 in the Philippines. The lot numbers are 5885, 5886, and 5887. The products were distributed to California, Hawaii, and Nevada. The recalled products were not sold directly to consumers by Sea Port.

The Toll:

As of August 31, 2016:

Since the last update, HDOH has identified 13 new cases of hepatitis A.  All cases have been in adults, 64 have required hospitalization.

Findings of the investigation suggest that the source of the outbreak is focused on Oahu. Ten (10) individuals are residents of the islands of Hawaii, Kauai, or Maui, and four visitors have returned to the mainland.

CONFIRMED CASES OF HEPATITIS A – 241

Onset of illness has ranged between 6/12/16 – 8/25/16.

Tropical Smoothie Café Hepatitis A Outbreak Update

The CDC, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of foodborne hepatitis A.  70 people with hepatitis A have been reported from seven states: Maryland (6), New York (1), North Carolina (1), Oregon (1), Virginia (55), West Virginia (5), and Wisconsin (1).  32 ill people have been hospitalized. No deaths have been reported. Epidemiologic and traceback evidence indicate frozen strawberries imported from Egypt are the likely source of this outbreak.

On August 8, 2016, Tropical Smoothie Café reported that they removed the Egyptian frozen strawberries from their restaurants in Maryland, North Carolina, Virginia, and West Virginia and switched to another supplier. Out of an abundance of caution, Tropical Smoothie Café has since switched to another supplier for all restaurants nationwide.

Contact your doctor if you think you may have become ill from eating a smoothie containing strawberries from a Tropical Smoothie Café prior to August 8, 2016 in the following states:

  • Virginia
  • West Virginia
  • Maryland
  • North Carolina

It is important that food handlers and restaurant employees contact their doctor and stay home if they are infected with hepatitis A. This helps prevent the virus from spreading. Not everyone will experience symptoms from a hepatitis A virus infection. Some people may experience mild flu-like symptoms. Other symptoms of hepatitis A virus infection include:

  • Yellow eyes or skin
  • Abdominal pain
  • Pale stools
  • Dark urine