When hearing about hepatitis A, many people think about contaminated food and water. However, in the United States, hepatitis A is more commonly spread from person to person. Since March 2017, CDC’s Division of Viral Hepatitis (DVH) has been assisting multiple state and local health departments with hepatitis A outbreaks, spread through person-to-person contact.

The hepatitis A vaccine is the best way to prevent hepatitis A virus (HAV) infection 

  • The following groups are at highest risk for acquiring HAV infection or developing serious complications from HAV infection in these outbreaks and should be offered the hepatitis A vaccine in order to prevent or control an outbreak:
    • People who use drugs (injection or non-injection)
    • People experiencing unstable housing or homelessness 
    • Men who have sex with men (MSM)
    • People who are currently or were recently incarcerated 
    • People with chronic liver disease, including cirrhosis, hepatitis B, or hepatitis C
  • One dose of single-antigen hepatitis A vaccine has been shown to control outbreaks of hepatitis A.1,2
  • Pre-vaccination serologic testing is not required to administer hepatitis A vaccine. Vaccinations should not be postponed if vaccination history cannot be obtained or records are unavailable.

CDC has provided outbreak-specific considerations for hepatitis A vaccine administration and has updated its overall recommendations on the prevention of hepatitis A virus infection in the United States.

The Long Beach Post reports that health officials in Long Beach notified recipients of Meals on Wheels that they may have been exposed to hepatitis A, a highly contagious liver infection, in late May and June.

The nonprofit delivers meals five times a week to about 400 people in Long Beach who can’t shop for themselves and live alone, most of them elderly. The Long Beach Health Department sent letters to those who consumed food delivered by the agency on May 23, May 31, June 6 and June 13, warning them of the possible exposure.

The individuals “were notified as standard public health practice, but the risk of developing Hepatitis A infection is low,” the Health Department said in a statement Thursday. “Meals on Wheels has cooperated fully and there is no ongoing risk to eating Meals on Wheels food.”

Meals on Wheels Executive Director Bill Cruikshank said the incident stemmed from a volunteer who was helping package food, but couldn’t provide further details due to privacy laws.

“This was a very low-risk exposure,” he said.

The Health Department advised those who were notified to get vaccinated for hepatitis A if they haven’t already, and to monitor any symptoms of the illness, which include diarrhea, stomach pain, dark-colored urine, fever, jaundice, nausea, vomiting, loss of appetite and muscle pain.

There is no treatment for the virus, which typically goes away on its own.

The virus is spread through contact with someone who is positive, or by ingesting food or water that has been contaminated with feces from an infected person.

As of May 31, 2022, a total of 18 outbreak-associated cases of hepatitis A have been reported from 3 states – California (16), Minnesota (1) and North Dakota (1).  Illnesses started on dates ranging from March 28, 2022, to May 6, 2022. Ill people range in age from 9 to 73 years, with a median age of 57.5 years. Sixty-seven percent of ill people are female. Of 18 people with available information, 13 (72%) have been hospitalized. No deaths have been reported.

Epidemiologic and traceback evidence indicate that fresh organic strawberries, imported from Baja California, Mexico, are the likely source of this outbreak. The potentially affected FreshKampo and HEB products are past shelf life and no longer available for purchase in the United States. People who purchased FreshKampo or HEB fresh organic strawberries during March 5, 2022, through April 15, 2022, and then froze those strawberries for later consumption should not eat them. These products may have been sold at the following retailers, including, but not limited to: HEB, Kroger, Safeway, Sprouts Farmers Market, Trader Joe’s, Walmart, Weis Markets, and WinCo Foods. One downstream recall from a company that may have used strawberries linked to this outbreak to make a product has been initiated. The recall is for Urban Remedy Organic Revitalizing Tea Tonic Strawberry Hibiscus Rose. People should not drink the recalled tea.

In Canada, As of June 2, 2022, there are 10 laboratory-confirmed cases of hepatitis A illness being investigated in two provinces: Alberta (4) and Saskatchewan (6). Individuals became ill between early and mid-April 2022. Individuals who became ill are between 10 to 75 years of age. Four individuals have been hospitalized. No deaths have been reported.

The CFIA is conducting a food safety investigation into the FreshKampo brand fresh organic strawberries purchased between March 5 and 9, 2022 at Co-op stores in Alberta and Saskatchewan. Currently, there are no food recall warnings associated with this outbreak.

The U.S. CDC and FDA are also investigating an outbreak of hepatitis A infections potentially linked to fresh organic strawberries. Investigators in Canada and the U.S. continue to collaborate to exchange information and identify commonalities in the outbreak information that may identify additional sources of illness or help to identify the cause of contamination in the fresh organic strawberries.

Total United States Illnesses: 17 – Canada 10

United States Hospitalizations: 12 – Canada 4

Illness onset dates range from March 28 – April 30, 2022.
States with Cases: California (15), Minnesota (1), North Dakota (1) – Provinces with Cases: Alberta (4) and Saskatchewan (6)

Product Distribution: United State and Canada

The FDA, along with CDC, the Public Health Agency of Canada and the Canadian Food Inspection Agency, state, and local partners are investigating a multistate outbreak of hepatitis A infections in the United States and Canada potentially linked to fresh organic strawberries branded as FreshKampo and HEB, purchased between March 5, 2022, and April 25, 2022.

Currently, the potentially affected FreshKampo and HEB products are past shelf life. People who purchased FreshKampo and HEB fresh organic strawberries between March 5, 2022, and April 25, 2022, and then froze those strawberries for later consumption should not eat them. These products were sold at the following retailers, including, but not limited to:

Aldi

HEB

Kroger

Safeway

Sprouts Farmers Market

Trader Joe’s

Walmart

Weis Markets

WinCo Foods

Canadian Co-op stores

Some past Hepatitis A Outbreaks linked to strawberries:

2016 Hepatitis A Linked to Frozen Strawberries, Tropical Smoothie Cafe – Several states, the CDC and the FDA investigated a multistate outbreak of foodborne hepatitis A linked to frozen strawberries imported from Egypt. Nearly all ill people interviewed reported drinking smoothies containing strawberries at Tropical Smoothie …Read More »

1997 Multistate Outbreak of Hepatitis A Linked to A&W Frozen Strawberries – A large outbreak of hepatitis A was associated with the consumption of strawberries served at school. The strawberries had been imported from Mexico and processed/packaged in California by A&W. They were frozen and sold for commercial use in school …Read More »

1990 Multistate Outbreak of Hepatitis A Linked Frozen Strawberries – Frozen strawberries that had been processed at a single plant were linked to outbreaks of hepatitis A. In Georgia, illnesses occurred among students and teachers at an elementary school. Three months, later, in Montana, an outbreak involving the strawberries …Read More »

The Maine Center for Disease Control and Prevention is warning consumers of possible hepatitis A exposure at a Boothbay convenience store.

A food service worker at T&D Variety at 601 Wiscasset Road, Boothbay, who was infected with hepatitis A, handled “to go” food on April 6 between 7 a.m. and 1 p.m., and on April 7 between 12:30 p.m. and 6 p.m., according to a release.

Hepatitis A is a contagious liver disease transmitted by food or water. It is preventable with a vaccine.

Patrons who purchased particular “to order” foods from the store during those times could be at risk for hepatitis A infection. No pre-made deli meals or other food or beverages were potentially contaminated.

The Maine CDC recommends that any deli food items made to order between those hours on those days be discarded.

Anyone who may have eaten food prepared in the deli during those hours should receive a hepatitis A vaccine within 14 days of their potential exposure. Those who have documentation of completing the hepatitis A vaccine series are protected and do not need to receive additional vaccination doses.

Anyone who ate food prepared at or who worked at this store during those days and hours should watch for symptoms including tiredness, low appetite, stomach pain, nausea, dark urine, and jaundice (yellowing of the skin or eyes) and seek medical attention if they develop symptoms.

Symptoms of hepatitis A range from mild to severe sickness requiring hospitalization and can last several months.
Most adults have sudden symptoms, while most children younger than six do not have symptoms.

Symptoms begin to show 15-50 days after exposure. An infected person can spread the virus to others approximately two weeks before symptoms appear until one week after symptoms end.

The Los Angeles County Department of Public Health (Public Health) is working with Sunlife Organics Juice Bar in West Hollywood to alert consumers of a possible hepatitis A exposure. 
The Los Angeles County Department of Public Health identified hepatitis A virus infection in a food handler who worked at this location.

No additional cases have been identified at this time.

Public Health recommends hepatitis A vaccination for patrons who consumed food or beverages from Sunlife Organics in West Hollywood between March 14–17, 2022. Vaccination is not necessary for people who previously completed the hepatitis A vaccine series or are known to have a past infection. To prevent infection or reduce illness, hepatitis A vaccine should be administered within 14 days after a known exposure.

Hepatitis A vaccinations might be available through local pharmacies or physicians’ offices. In addition, Public Health will be offering free hepatitis A vaccinations to exposed persons at:

Hollywood Wilshire Health Center 
5205 Melrose Ave. 
Los Angeles, CA 90038

· Sunday, March 27, 2022 from 10am-1pm

· Monday, March 28, 2022 from 10am – 1pm

· Tuesday, March 29, 2022 from 8am – 4pm

Most people will have protective levels of antibody after one dose of the Hepatitis A vaccine but can choose to visit their primary care provider to complete the series with a second dose 6 months after receiving their first dose.

Hepatitis A is a liver infection caused by the hepatitis A virus. Hepatitis A causes acute liver disease, which may be severe. Hepatitis A is highly contagious and can be spread from person-to-person through the fecal-oral route (when contaminated feces from an infected person are somehow ingested by another person during close personal contact) or by eating or drinking contaminated food or water). Most adults with acute hepatitis A will have symptoms that may include fever, fatigue, nausea, vomiting, abdominal pain, dark colored urine and jaundice (yellowing of the skin or eyes). There is no specific antiviral treatment.

Vaccination is the best way to prevent disease. In addition, infection can be prevented by vaccination within 14 days after a known exposure to a person with infectious hepatitis A. Older adults and people with weakened immune systems might benefit from receiving immune globulin (IG) in addition to hepatitis A vaccination for prevention after an exposure. For any questions about hepatitis A or the need for immune globulin, Public Health recommends that you speak to your primary care provider. If you do not have a regular provider, call 2-1-1 for assistance.

Public Health will continue monitoring all known individuals who may have been exposed to individuals ill with hepatitis A

A Montgomery County restaurant reopened Monday following a hepatitis A investigation.

Gino’s Ristorante and Pizzeria closed on Jan. 7. Ten total cases are being reviewed and three people have died from the virus.

On Jan. 7, the popular family-owned restaurant that opened back in 1972 was forced to temporarily close following a hepatitis A investigation.

According to the Montgomery County Health Department, of the 10 confirmed cases, seven people were hospitalized and three have died.

While the source of the outbreak has not been confirmed, officials say they traced the virus to back to this site in late November but can’t say if it was a worker or contaminated food product.

The Roanoke City and Alleghany Health Districts (RCAHD) in Virginia announced that RCAHD has identified a total of 50 confirmed primary cases and 2 secondary cases of hepatitis A. There have been at least 31 hospitalizations and unfortunately 3 deaths linked to Famous Anthony’s restaurants.

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 $800 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.

Additional Resources:

What is Hepatitis A?

Hepatitis A is the only common vaccine-preventable foodborne disease in the United States. It is one of five human hepatitis viruses that primarily infect the human liver and cause human illness. Unlike hepatitis B and C, hepatitis A doesn’t develop into chronic hepatitis or cirrhosis, but in rare cases infection with hepatitis A virus can lead to a more rapid onset of liver failure and death.

How do you contract Hepatitis A?

Hepatitis A is a contagious disease that is transmitted by the “fecal – oral route,” either through person-to-person contact or contaminated food or water. Food-related outbreaks are usually traced to food that has been contaminated by an infected food handler. Fresh produce contaminated during cultivation, harvesting, processing, and distribution has also been a source of hepatitis A.

What are the signs and symptoms of Hepatitis A?

Symptoms typically begin about 28 days after infection but can begin as early as 15 days or as late as 50 days after exposure. Symptoms may include headache, loss of appetite, nausea, vomiting, abdominal discomfort, fatigue, joint pain, dark urine, clay colored bowel movements, and fever. Jaundice, a yellowish discoloration of the skin and whites of the eyes, occurs in most cases. Hepatitis A may cause no symptoms at all when it is contracted, especially in children. Those infected usually recover fully within 2 to 6 months.

What to do if you become infected with Hepatitis A:

Infection is determined by a blood test. If you know you have been exposed to hepatitis A, immune globulin shots or a hepatitis A vaccine can reduce your chance of infection by up to 90%.

How to Prevent a Hepatitis A Infection:

Ask your health care provider about vaccination – there are many reasons to seriously consider it, including working with food or ill persons, travel, or an impaired immune system. Children who contract hepatitis A but have no symptoms can also pass the virus through ordinary play to their parents. Make sure your childcare providers are vaccinated and be aware of friends and relatives who may have traveled to countries with high rates of infection. Stay alert to notices of outbreaks to determine if your family has been exposed.

The hepatitis A lawyers of Marler Clark have many years of experience working with clients on Hepatitis A outbreak lawsuits.

Hepatitis A is one of five human hepatitis viruses (hepatitis A, B, C, D, and E) that primarily infect the liver and cause illness. It is a communicable (or contagious) disease that spreads from person-to-person through fecal-oral contact, often from an infected food handler contaminating food. The cases the Marler Clark hepatitis A lawyers have been involved in have generally resulted from contaminated food or water.

An estimated 80,000 hepatitis A cases and an estimated 100 deaths due to acute liver failure brought on by hepatitis A occur each year in the U.S. The rate of infection has dramatically decreased since the hepatitis A vaccine was licensed and became available in 1995. Despite the decrease in hepatitis A cases nationally, Marler Clark has represented clients young and old who have become ill with hepatitis A after eating contaminated food or who were exposed to the virus and had to receive an injection to prevent illness.

The Marler Clark hepatitis A attorneys have unmatched experience representing victims of hepatitis A. Our law firm represented victims of notable hepatitis A outbreaks such as the 2003 Chi Chi’s hepatitis A outbreak, the 2005 California lettuce hepatitis A outbreak, and the 2010 Quad-Cities McDonald’s hepatitis A outbreak. Contact us today to learn more about our services.

An employee who worked at three Famous Anthony’s restaurant locations in Roanoke has been diagnosed with hepatitis A. As a result, the Roanoke City and Alleghany Health Districts (RCAHD) announced today that anyone who visited any of these three Famous Anthony’s locations — 4913 Grandin Road, 6499 Williamson Road or 2221 Crystal Spring Ave. — from August 10 through 26 only, may have been exposed.

The RCAHD is currently investigating nine cases of hepatitis A associated with this exposure.

To protect your health and prevent further spread of illness, if you meet these criteria and are not vaccinated against hepatitis A, please monitor yourself for these symptoms:

• jaundice: yellowing of the skin or the eyes,
• fever,
• fatigue,
• loss of appetite,
• nausea,
• vomiting,
• abdominal pain,
• dark urine, or
• light-colored stools.

If you develop any of these symptoms, please seek medical care and let your healthcare provider know of your possible exposure. It is also very important for people with symptoms to stay home from work, especially if they work in food service, health care or child care.