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Hepatitis Blog

Surveillance & Analysis on Hepatitis News & Outbreaks

93 with Hepatitis A in Hawaii

At least a 93 person hepatitis A outbreak that has left 29 hospitalized as of July 26, 2016.

Ill people have also been located on the islands of Hawaii, Kauai and Maui, but the had been visiting Oahu in the weeks before the onset of their illnesses.

The onset of ill has ranged from June 12, 2016 to July 19, 2016.  Therefore in essence this outbreak is growing and ongoing.

The Health Department has suggested that unvaccinated contacts of cases should talk to their healthcare providers about the possibility of receiving hepatitis A vaccine or immune globulin, which may provide some protection against the disease if administered within the first two weeks after exposure.

A contact is defined as:

  • All unvaccinated household members
  • All unvaccinated sexual contacts
  • Anyone sharing illicit drugs with a case
  • Anyone sharing food or eating or drinking utensils with a case
  • Anyone consuming ready-to-eat foods prepared by an infectious food handler with diarrhea or poor hygiene 

Unvaccinated food handlers who are contacts of cases must have a negative hepatitis A IgM test before they return to work. 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.


Sushi Shiono

Taco Bell


Mystery Hawaiian Hepatitis A Outbreak Sickens 52 and Puts 14 in Hospital

UnknownHHThe Hawaii State Department of Health (DOH) is investigating a confirmed case of Hepatitis A in a food service employee at the ice cream specialty store, Baskin-Robbins, located at the Waikele Center in Waipahu. The department is advising persons who consumed any food or drink products from this store between June 17 and July 3, 2016 (actual dates: June 17, 18, 19, 21, 22, 25, 27, 30, and July 1 and 3) they may have been exposed to the disease. Unvaccinated individuals should contact their healthcare providers about the possibility of receiving hepatitis A vaccine or immune globulin, which may provide some protection against the disease if administered within the first two weeks after exposure.

This individual is one in a growing number of ill reported to DOH. Since the outbreak began, there have been 52 cases of hepatitis A reported to and now confirmed by DOH. All cases have been in adults on Oahu, 16 have required hospitalization. The department issued a Medical Advisory to all healthcare providers on June 30 urging them to be vigilant and report all suspected hepatitis A infection immediately.

“The source of this outbreak has still not been determined. In the meantime, we encourage all persons consider and talk to their healthcare provider about getting vaccinated,” said State Epidemiologist Dr. Sarah Park. “This case demonstrates the potential to spread hepatitis A virus to many others who remain susceptible. In an effort to stem the spread of disease, individuals, including food service employees, exhibiting symptoms of hepatitis A infection should stay home and contact their healthcare provider.”

Symptoms of hepatitis A infection include fever, fatigue, loss of appetite, abdominal discomfort, dark urine, diarrhea, and yellow skin and eyes, and typically last several weeks to as long as two months. Treatment of hepatitis A is supportive, and most people will recover without complications.

While vaccination provides the best protection, frequent handwashing with soap and warm water after using the bathroom, changing a diaper, and before preparing food can help prevent the spread of hepatitis A. Appropriately cooking foods can also help prevent infection.

Hepatitis A vaccine is readily available at local pharmacies. Two doses of hepatitis A vaccine, given at least six (6) months apart, are needed for lasting protection. For a list of vaccinating pharmacies, visit http://health.hawaii.gov/docd/files/2013/07/IMM_Adult_Resource_List.pdf or call the Aloha United Way information and referral line at 2-1-1.

Hepatitis A Fear in Custer Pizza Works

A case of hepatitis A has been reported in a food handler at the Pizza Works restaurant in Custer. The food handler worked shifts between June 19 and July 5. Individuals who ate at the restaurant during that time period should contact their health care provider to determine if they need a shot of immune globulin which minimizes their chances of becoming ill or if they should be considered for vaccination.

Pizza Works is cooperating with the department on the investigation.

Hepatitis A is a liver disease caused by a virus. The virus can be carried on an infected person’s hands and can be spread by direct contact, or by consuming food or drink that has been handled by the individual.

Symptoms may include fatigue, poor appetite, fever, abdominal discomfort, and vomiting. Urine may become darker, and then jaundice (a yellowing of the skin and eyes) may appear. The disease is rarely fatal and most people recover in a few weeks without any complications. Infants and young children tend to have very mild symptoms and are less likely to develop jaundice than are older children and adults. Not everyone who is infected will have all of the symptoms.

The single most effective way to prevent the spread of hepatitis A is careful hand-washing after using the toilet. Also, infected people should not handle foods during the contagious period, which begins two weeks before symptoms appear and extends a few days after jaundice appears.

Hawaii Hepatitis A Outbreak a Mystery

AP reports that the Hawaii State Department of Health says an Oahu outbreak of hepatitis A has grown to 31 confirmed cases.

The department says staff members worked through the holiday weekend to interview infected patients in an effort to find the cause of the infection.

State Epidemiologist Sarah Park says identifying the cause is difficult. She says accurately recalling all of the food consumed and locations visited during the infection period is challenging, especially for those who are still feeling ill.

Health officials say the virus can be spread by eating contaminated food, drinking contaminated water, close personal contact or sex. Symptoms include fever, fatigue, appetite loss, abdominal discomfort and diarrhea.

The department said last week there were at least 12 cases of hepatitis A on Oahu.

Hepatitis A Outbreak Hits Oahu

The Health Department is eying poke as one of dozens of possible culprits, but health officials stressed the investigation remains preliminary.

AP reports that the state Department of Health is investigating an outbreak of hepatitis A on Oahu.

The department said Friday there are at least 12 cases of hepatitis A infection in adults. Six of them have required hospitalization.

Onsets of the illnesses range from June 16 through June 27.

Health officials say the virus can be spread by eating contaminated food, drinking contaminated water, close personal contact or sex. Symptoms include fever, fatigue, appetite loss, abdominal discomfort and diarrhea.

Health Director Dr. Virginia Pressler says it’s a vaccine-preventable disease. She says that while it’s a routine childhood vaccination, many adults haven’t been vaccinated and remain susceptible.

The vaccine is readily available at local pharmacies.

Hepatitis A Linked to Costco

The Public Health Agency of Canada is collaborating with federal and provincial public health partners to investigate an outbreak of Hepatitis A infections in three provinces linked to the frozen fruit product: Nature’s Touch Organic Berry Cherry Blend. The Canadian Food Inspection Agency (CFIA) has issued a food recall warning advising Canadians of the recall of the frozen fruit product that has been distributed in Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador.

The Public Health Agency of Canada advises Canadians not to consume the frozen fruit product Nature’s Touch Organic Berry Cherry Blend sold exclusively at Costco warehouse locations in Ontario, Quebec, New Brunswick, Nova Scotia, and Newfoundland and Labrador.

The overall risk to Canadians is low. Hepatitis A is a disease that can cause inflammation of the liver. Hepatitis A can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. You can get the Hepatitis A virus by eating contaminated food or water or through contact with an infected person’s stool. Adequate vaccination can protect against the Hepatitis A virus.

Currently, there are 12 cases of Hepatitis A in three provinces related to this outbreak: Ontario (9), Quebec (2), and Newfoundland and Labrador (1). Individuals became sick in February and March of this year. Some of the individuals who became ill have reported eating the recalled product. The majority of cases (58%) are male, with an average age of 37 years. Three cases have been hospitalized.

Sandy Cinema Patrons Urged to get Hepatitis A Treatment

Clackamas County Public Health officials are investigating an incident of potential exposure to Hepatitis A at a Sandy movie theater.

People who attended the Sandy Cinema, at 16605 Champion Way in Sandy, and ate or drank from the concession stand during certain days and hours earlier this month may have been exposed.

The specific days and hours in question are:

  • Feb. 12: 11 a.m. to closing
  • Feb. 13: 6 p.m. to closing
  • Feb. 14: 2 p.m. to closing
  • Feb. 15: 1:30 p.m. to closing

Clackamas County Public Health is advising people who may have been exposed to check their immunization status, and if they have not been immunized against Hepatitis A, to obtain medication that can decrease their chances of becoming ill. These are effective for up to two weeks after exposure.

The medication should not be given if more than two weeks have passed.

  • Those individuals aged 1 to 40, who have not previously received the Hepatitis A vaccine, are recommended to get a single dose of the vaccine. Twinrix (which is a combination Hepatitis A and B vaccine) is not appropriate for this purpose.
  • For those individuals less than 12 months old or over 40, vaccine is not approved. They are recommended to receive immune globulin shots.

Clackamas County Public Health also has established a call-in line to provide information. The call-in number is 503-742-5320. The call center will be active through 7 p.m. tonight and from 9 a.m. to 4 p.m. Saturday.

Clackamas County is updating inventories in the region to assure there is adequate supply. For questions about where to find vaccine please contact the call center.

Medications will also be made available Tuesday, Wednesday and Thursday, Feb. 23 through Feb. 25 at Legacy Medical Group Firwood, 36860 Industrial Way, Sandy, from 6:30 to 9 p.m.

The Hepatitis A case was first reported to Clackamas County Public Health late on February 17.

Public Health officials said theater owners have been fully cooperative and stressed that the risk to the public is extremely low and there is no continued risk to the public.

“This recommendation for treatment doesn’t apply to people who ate at Sandy Cinema on other days,” said Dr. Sarah Present, Clackamas County Public Health Officer. ”We know the likelihood of infection is low but we are recommending vaccinations for exposed persons because the risk is not zero and there are effective medications that can further decrease the risk of illness.”

Hepatitis A is a viral disease of the liver that is contagious. It is spread from person to person, often by inadequate handwashing after using the toilet or changing diapers, or eating food prepared by an infected person.

Typical symptoms include fatigue, fever, and loss of appetite, abdominal pain, nausea, vomiting, or jaundice (a yellowing of the skin or eyes). Some infections may be mild but it can develop into severe liver disease. Symptoms usually develop 3-4 weeks after exposure but it may be up to 50 days.

For more information, go to the Clackamas County Public Health Division web page at: www.clackamas.us/publichealth/

Seneca County Health Department Reports Hepatitis A Ill Employee at Mark’s Pizzeria

The Seneca County Health Department has confirmed a case of Hepatitis A in a food service worker. The food service worker is employed at the Marks Pizzeria located at 1963 Kingdom Plaza, Waterloo, NY 13165. Public health officials state that individuals not previously vaccinated for Hepatitis A and who consumed cold foods, such as subs, salads, vegetables, lemons and celery sticks from Mark’s Pizzeria should seek treatment.

Anyone previously immunized for Hepatitis A by their physician or through clinics recently held by the Seneca County Health Department DO NOT need to be re-immunized.

Individuals who consumed cold foods from the Mark’s Pizzeria located at 1963 Kingdom Plaza, Waterloo, NY 13165 on November 13, 2015 through Wednesday, November 18, 2015 are advised to monitor themselves for signs and symptoms of Hepatitis A for the next 4-6 weeks.

If you consumed cold foods from Mark’s Pizzeria located at 1963 Kingdom Plaza, Waterloo, NY 13165 on Thursday, November 19, 2015 through Saturday, November 28, 2015, you should seek treatment for Hepatitis A.  Clinics will be held in the Seneca County Office Building located at 1 DiPronio Drive Waterloo, NY 3rd Floor Board of Supervisor’s Room on Thursday, December 3, 2015- 1:00 pm-7:00 pm, Monday, December 7, 2015 – 3:00 pm-7:00 pm and Thursday, December 10, 2015- 12:00 pm-4:00 pm.

Individuals are strongly encouraged to preregister and arrive during their scheduled appointment times.

To pre-register visit www.co.seneca.ny.us or for more information call the New York State Department of Health Hotline at 1-844-364-6397.

Waterloo New York McDonalds Hepatitis A Worry

The Seneca County Health Department has confirmed a case of Hepatitis A in a food service worker employed at the McDonalds located at 2500 Mound Rd. Waterloo, NY. Public health officials are stressing there is a low risk of contracting illness, however, individuals who have not been previously vaccinated for Hepatitis A and who consumed food/drink from McDonalds on the following dates should consider treatment.

If you ate at McDonald’s at 2500 Mound Rd. Waterloo, NY on 10/31 you should attend the 11/14/15 clinic.

If you ate at McDonald’s at 2500 Mound Road Waterloo, NY on any of the following dates you should attend either the 11/14 or the 11/15 clinic.

Monday, November 2nd, 2015

Tuesday, November 3rd, 2015

Thursday, November, 5th 2015

Friday, November 6th 2015

Sunday, November 8th 2015

Clinics will be held offering Hepatitis A Vaccine

Saturday, November 14, 2015- 1:00 pm-8:00 pm

Sunday, November 15, 2015 – 10:00 am-4:00 pm

Mynderse Academy Gymnasium

105 Troy Street

Seneca Falls, NY 13148

To preregister for a clinic www.health.state.ny.us/gotoclinic/50

For other additional questions: New York State Department of Health Hotline: 1-844-364-6397

Waterloo/Seneca Falls Hepatitis A FAQ

What happened at the McDonalds in Waterloo?

A worker at the McDonalds on Route 414 and Mound Road in Waterloo NY, a short distance from Exit 41 off the NYS Thruway, worked while they may have been shedding Hepatitis A virus, before the worker was diagnosed with the illness. Because of how Hepatitis A is spread, this may have put customers and coworkers at that McDonalds at risk of acquiring Hepatitis A.

Did Humans Pick Up Hepatitis A From Animals?

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.