State health officials are warning recent patrons of Cap’n Fish’s Boothbay Harbor Boat Trips may have be at risk for acute hepatitis A virus infection.

An announcement Saturday from the Maine Center for Disease Control and Prevention said a food service worker  prepared food while infectious from Aug. 18 through Sept. 8, and that patrons of the Boothbay Harbor business may be exposed. Hepatitis A is a contagious liver disease, whose symptoms can range from mild illness to severe sickness that could require hospitalization.

The business provides scenic cruises and whale-watching trips for visitors to the region.

To reduce the likelihood of illness, the Maine CDC recommends that anyone who ate, drank or worked at Boothbay Harbor Boat Trips in Maine on Sept. 2, 4, and 5 should get the hepatitis A vaccine. People with compromised immune systems, or parents of children younger than 12 months, should consult a health care provider about receiving hepatitis A immune globulin.

People who visited the Cap’n Fish’s Boothbay Harbor Boat Trips on Aug. 19, 21, 22, 23 24, 26, 28, 29 and 30 could have been exposed but are outside the window for which the vaccine could help prevent illness from this exposure, said the Maine CDC. Those individuals should watch for symptoms and seek medical attention if they develop any symptoms.

The state agency is working with the business owner and local health care providers to notify affected parties and minimize risk of further exposure.

The investigation by the Douglas County Health Department Missouri found that this employee worked while infectious Aug. 30-31. Ruby Garden is working with Douglas County Health Department to prevent any new illnesses from arising in the community because of this case.

While it is uncommon for restaurant patrons to become infected with hepatitis A virus due to an infected food handler, anyone who consumed food or drink at Ruby Garden during the dates of Aug. 30-31 is recommended to receive the hepatitis A vaccination within 14 days following the exposure as further protection from becoming ill. Persons who are concerned about the hepatitis A outbreak but did not consume food or drink at the Ruby Garden during the dates noted are asked not to come to the vaccination clinics scheduled for patrons of the restaurant. For any questions or to schedule an appointment, contact the Douglas County Health Department at 417-683-4213.

The Douglas County Health Department will be providing vaccinations at no cost for patrons of Ruby Garden who consumed food or drink during the dates of Aug. 30-31, at 608 NW 12th Ave, Ava, Mo. 65608 on:

  • Saturday, Sept. 7; 9-11 a.m.
  • Monday, Sept. 9; 9-11 a.m.
  • Monday, Sept. 9; 1-4 p.m.

In Indiana, Linton’s Long John Silvers closed voluntarily Thursday for cleaning after an employee tested positive for Hepatitis A, according to Greene County health officials.

The Greene County Health Department determined the “risk of infection is very low for patrons who visited the restaurant earlier this month,” according to a statement released Thursday.

Health officials say they have been working with the establishment at 1600 A Street NE, since Tuesday to confirm an infected employee, and to ensure proper cleaning measures are taken.

The investigation concluded Wednesday afternoon with the Indiana State Department of Health determining this was a low-risk situation.

Anyone who consumed food or drink at these restaurants are also asked to:

  1. Monitor their health for symptoms of hepatitis A infection up to 50 days after exposure.
  2. Wash their hands with soap and warm water frequently and thoroughly, especially after using the bathroom and before preparing food.
  3. Stay at home and contact their health care provider immediately if symptoms of hepatitis A infection develop.

Hepatitis A is a viral infection of the liver that can cause loss of appetite, nausea, tiredness, fever, stomach pain, brown colored urine, and light-colored stools. Yellowing of the skin or eyes might also occur. People can become ill up to 7 weeks after being exposed to the virus. If you think you have symptoms of hepatitis A, you should contact your health care provider.

Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool (poop) from an infected person. Careful hand washing with soap and water, including under the fingernails, after using the bathroom or changing diapers and before preparing or eating food will help prevent the spread of this disease.

The Southern Nevada Health District has identified a person with hepatitis A that worked at a 7-Eleven convenience store located at 2910 S. Maryland Parkway, Las Vegas, NV 89109 (Maryland Parkway and Vegas Valley Drive) while they were potentially infectious to others. Although transmission of hepatitis A from food handlers to patrons is rare, the Health District is informing customers who purchased non-prepackaged foods such as hot dogs or hot deli items between Friday, July 26 and Friday, Aug. 7, 2019, at this 7-Eleven location that they may have been exposed to the virus.

Customers who purchased food at this location should contact their health care providers about getting a hepatitis A immunization or receiving post-exposure treatment. Packaged items, including bottled beverages and microwaved foods, are not implicated in this potential exposure. Customers who are fully vaccinated (two doses) against hepatitis A or who consumed only packaged or bottled items are not at increased risk.

This person is considered linked to the ongoing outbreak in Clark County. Currently, there are 86 reported cases, and one person has died. Updated outbreak reports are available on the Health District website at www.SNHD.info/hep-a-control.

Hepatitis A is commonly spread from person-to-person through the fecal-oral route. Symptoms include jaundice (yellowing of the skin and eyes), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, and light-colored stools. Vaccination is the best prevention against hepatitis A. Practicing good hygiene can also help prevent the transmission of hepatitis A. Wash hands thoroughly after using the bathroom, changing diapers, and before preparing or eating food.

Food handlers are not at increased risk for hepatitis A virus because of their occupation. Most food handlers with hepatitis A virus infection do not transmit it to exposed consumers or patrons. During ongoing outbreaks, transmission from food handlers to restaurant patrons has been extremely rare due to sanitation standards and food safety practices that help prevent the spread of the virus. The Centers for Disease Control and Prevention (CDC) does not recommend vaccinating all food handlers because it would not be an effective method of stopping an outbreak. Hepatitis A outbreaks primarily affect individuals who report using injection or non-injection drugs and people experiencing homelessness.

For information about the Health District’s immunization clinics, call (702) 759-0850. Immunizations are available at the following locations. Please arrive by 4 p.m. to allow time for processing:

  • Main Public Health Center, 280 S. Decatur Blvd., Las Vegas
    Monday – Friday, 8 a.m. – 4:30 p.m.
  • East Las Vegas Public Health Center, 570 N. Nellis Blvd., Suite D1, Las Vegas
    Monday – Friday, 8 a.m. – 4:30 p.m.
  • Southern Nevada Health District Henderson Clinic, 874 American Pacific Dr., Henderson
    Monday – Thursday, 8 a.m. – 4:30 p.m., Friday 8 a.m. – 1 p.m.
    Closed daily 1 p.m. – 2 p.m.
    By appointment only. Call (702) 759-0960.
  • Mesquite Public Health Center, 830 Hafen Lane, Mesquite
    Tuesday and Thursday, 8 a.m. – 4:30 p.m. Closed noon – 1 p.m.
    By appointment only. Call (702) 759-1682.

The New Jersey Department of Health is working with the Mendham Township Health Department and the Mendham Golf and Tennis Club (MGTC) in response to a hepatitis A outbreak related to a food handler at the club. MGTC is a members only club.

Hepatitis A is an immediately reportable condition to the Department and the local health department; through this mechanism this case was identified.    The Department of Health is supporting the Mendham Township Health Department—which began immediately investigating. The food handler was excluded from work and a review of other food handlers for vaccination and proof of immunity was conducted.  Close contacts of the food handler were identified and given prophylaxis (vaccine or medication to prevent illness after exposure). MGTC first notified their membership on July 5, 2019 of the potential risk to those who dined at the club. This same notification advised members to inform any guests who may have joined them to dine at the club. This notification also advised that those who dined at the club when the food-handler was potentially infectious should receive post-exposure prophylaxis (vaccine or medication to prevent illness after exposure). if you dined at the country club between June 9 and June 30, 2019 and have symptoms or concerns, you should contact your health care provider.

Hepatitis A is mainly spread via close person to person contact or via contaminated food. While individuals with hepatitis A may be quite ill, the risk of transmission is to those who had close contact to the case and patrons of the club who consumed food prepared by the ill worker.

There are 23 confirmed cases including one individual who is seriously ill.

Since January 2019, Southwestern Idaho has seen an increase in Hepatitis A cases. Though a common link among cases has not been identified, public health encourages you to protect yourself by getting vaccinated for hepatitis A and using proper hand hygiene.

7/17/2019: Hepatitis A case confirmed in food service worker employed at Saint Lawrence Gridiron, located at 705 W. Bannock Street in Boise

The food service employee worked various days and shifts during the period they were contagious. Based on the infectious period of hepatitis A, anyone who ate at Saint Lawrence Gridiron on the following dates should check their immunization records to see if they have received a hepatitis A vaccine:

June 21, 22, 23, 24 (2019)
June 27, 28, 29, 30 (2019)
July 1 (2019)
July 5, 6, 7, 8 (2019)
July 11, 12, 13, 14, (2019)

The risk of becoming infected with hepatitis A through an infected food service worker is low but CDHD encourages anyone who ate on any of the dates identified, and has not received a hepatitis A vaccine, or is unsure about their vaccine status, to consider getting vaccinated. CDHD is offering free hepatitis A vaccine to anyone who ate at this restaurant on an identified date listed above. Call 208-321-2222 to make an appointment at CDHD.

In order for the hepatitis A vaccine to help prevent possible transmission, patrons must get the vaccine within two weeks of the date they may have been exposed.

Those with questions about their immunization record, who wish to make a vaccine appointment or have questions related to hepatitis A and potential exposure at this restaurant may call 208-321-2222.

Potentially exposed patrons should also watch for symptoms of hepatitis A which may include abdominal pain, dark urine, fatigue, fever, jaundice (yellowing of the skin and eyes), light-colored stools, loss of appetite, nausea and vomiting. Hepatitis A symptoms typically develop around 4 weeks after exposure if you have been infected. If symptoms occur, seek medical attention.

Westchester County Health Department was notified of the first case in what would be identified as the Bartaco hepatitis A outbreak on October 10, 2017. Bartaco is a Mexican restaurant located at 1 Willett Ave, Port Chester, New York.

After learning of a second hepatitis A case with exposure to Bartaco, environmental health investigators conducted facility inspections of the restaurant on October 17 and 19. The Health Departments also provided preventative treatment and timely information to more than 3,000 people who were exposed to the confirmed HAV-infected Bartaco employee.  The inspections found several violations that could have contributed to the spread of hepatitis A to patrons. The Health Departments’ observations included inadequate employee hand washing facilities, and employees handling cooked and prepared foods with bare hands. Additionally, investigators observed that food items were not properly protected during storage and preparation from potential sources of contamination.

The Centers for Disease Control (CDC) performed  genetic analysis of the Hepatitis A strains from the 3 original Westchester residents who ate at Bartaco as well as the HAV-infected employee. The results demonstrated that all the individuals were infected with the same strain of Hepatitis A which was not being seen elsewhere in the United States. Id.

Ultimately, the investigation conducted by the Westchester County Health Department determined that the six laboratory confirmed cases of hepatitis A were associated with the Bartaco hepatitis A outbreak. All six cases had eaten at Bartaco Restaurant between October 12 and 23. It was concluded that the source of the outbreak was an ill employee who worked at the restaurant while infectious. This conclusion was based on (1) one of the initial four primary cases was also a Bartaco employee; (2) none of the primary cases knew each other or ate at the same time; the only commonality among the confirmed cases was their consumption of food and drink from Bartaco from September 7—12, 2017; (3) observations by WCDOH environmental inspectors indicated violations related to bare-hand contact with foods, utensils, and inadequate handwashing facilities for Bartaco staff; (4) subsequent investigation of food sources for the Bartaco brand indicated that all locations are serviced by the same supplier, and no other Bartaco restaurant experienced similar illness; and (5) while no ill employee was ultimately identified from September 2017, 22 employees who worked during that time were unable to be interviewed and investigated as a possible index case.

The conclusions made by the Westchester County Health Department are supported by the plaintiff’s expert witness Kristin Sweet, PhD, MPH. Ms. Sweet has an extensive background in public health, epidemiology, foodborne illness investigations, and viral infections, working specifically as an infectious-disease epidemiologist for viral hepatitis for 13 years.

Specifically, Kristin Sweet, PhD, MPH, concluded:

The only common exposure among the five primary cases of hepatitis A in this outbreak was having eaten at Bartaco in Port Chester, NY. During an inspection of the restaurant, gaps in sanitation practices were identified including bare‑hand contact with ready‑to‑eat foods and lack of handwashing supplies at sinks. Although the epidemiological investigation did not implicate a specific food item or food handler as the source of the infections, the environmental health assessment at the restaurant found food‑handling practices that could have led to contamination.

According to the NEARS Form, the restaurant did not have a salad bar or buffet where customers could more easily contaminate food consumed by other patrons. Employees and customers used separate restrooms and cases occurred both in customers and one employee. While hepatitis A can survive on environmental surfaces for a month or more, the likelihood that a customer contaminated a surface that was touched by multiple patrons on multiple days resulting in infection is low. Despite the fact that the NYDOH reported that no source was identified through their investigations, an ill food handler is still a possible source. These interviews depend on the availability of all employees completing an interview or survey. Even if all employees were interviewed, employees may not be honest or be able to report thoroughly on their symptom history from one or more months prior to interview. In the absence of complete documentation on the employee interviews, either of these scenarios is possible in this instance.

Based on the information provided to me, it is more likely than not that the hepatitis A outbreak at Bartaco was foodborne.

A second expert, Roy E. Costa, RS, MS (MBA), a Public Health Sanitarian and Consultant with over twenty years’ experience reached a similar conclusion, providing the following opinions of the case:

1.     Bartaco was the source of 5 primary HEP A outbreak cases.

2.     There were 2 secondary outbreak cases related to the primary cases.

3.     A HEP A infected Bartaco co-worker was the most likely source of the HEP A virus.

4.     The HEP A Positive employee and 4 other primary cases in October were exposed to an unidentified infected co-worker in September of 2017.

5.     A contaminated food and beverage were the most likely modes of HEP A virus transmission.

6.     The most likely contributing outbreak factors were poor maintenance of hand washing facilities, poor personal hygiene practices, lack of hand washing, bare-hand contact of RTE foods, and poor management surveillance.

Hepatitis A case confirmed in food service worker employed at Saint Lawrence Gridiron, located at 705 W. Bannock Street in Boise

The food service employee worked various days and shifts during the period they were contagious. Based on the infectious period of hepatitis A, anyone who ate at Saint Lawrence Gridiron on the following dates should check their immunization records to see if they have received a hepatitis A vaccine:

June 21, 22, 23, 24 (2019)
June 27, 28, 29, 30 (2019)
July 1 (2019)
July 5, 6, 7, 8 (2019)
July 11, 12, 13, 14, (2019)

The risk of becoming infected with hepatitis A through an infected food service worker is low but CDHD encourages anyone who ate on any of the dates identified, and has not received a hepatitis A vaccine, or is unsure about their vaccine status, to consider getting vaccinated. CDHD is offering free hepatitis A vaccine to anyone who ate at this restaurant on an identified date listed above. Call 208-321-2222 to make an appointment at CDHD.

In order for the hepatitis A vaccine to help prevent possible transmission, patrons must get the vaccine within two weeks of the date they may have been exposed.

Those with questions about their immunization record, who wish to make a vaccine appointment or have questions related to hepatitis A and potential exposure at this restaurant may call 208-321-2222.

Potentially exposed patrons should also watch for symptoms of hepatitis A which may include abdominal pain, dark urine, fatigue, fever, jaundice (yellowing of the skin and eyes), light-colored stools, loss of appetite, nausea and vomiting. Hepatitis A symptoms typically develop around 4 weeks after exposure if you have been infected. If symptoms occur, seek medical attention.

The Genesee County Health Department has recently been awarded a grant to provide the hepatitis A vaccine to food-service workers at NO COST to them or the employer.

In Western New York and across the United States, foodborne outbreaks of hepatitis A have occurred as a result of infected food-service workers.

Brenden Bedard, director of Community Health Services for Genesee and Orleans counties, understands the severity of hepatitis A and the effect it can have on a business and community.

“Hepatitis A is a serious issue because most food-service workers will spread the infection before even knowing they have the disease,” Bedard said. “A food-service worker can spread the virus to customers or other staff by contaminating surfaces, utensils and/or food, which can make unvaccinated individuals very sick.

“By offering the vaccine to food-service workers, we can prevent unnecessary illness from spreading in the community.”

Hepatitis A is a contagious (spreadable) liver infection that is caused by the hepatitis A Virus (HAV). It is typically spread through the feces (poop) of infected individuals.

Someone can become infected by consuming food or drink that has been contaminated by feces as well as having close personal contact with a person who is infected, or use of injection and non-injection drugs.

The symptoms of HAV may include sudden onset of fever, loss of appetite, nausea / vomiting, stomach pain, dark-colored urine and jaundice (a yellowing of the skin and whites of the eyes). HAV usually does not have signs or symptoms until the second week of infection and is the most infectious during this time.

The good news is that hepatitis A can be prevented through vaccination!

According to the Centers for Disease Control and Prevention (CDC), the vaccine has a 94- to 100-percent efficacy rate.

The hepatitis A vaccine is a two-dose series that is administered six months apart. As the vaccine is not required to attend school or daycare, many people have not received it.

Currently three local restaurants have taken advantage of this opportunity for themselves and their employees who chose to receive the vaccine. The restaurants who have participated thus far have all expressed gratitude knowing their employees can protect themselves and their customers from the hepatitis A virus.

Any food-service worker employed in Genesee County can receive the vaccine.

By receiving the vaccine, you are also protecting yourself from getting the virus if you come in contact with dishes and/or utensils that may have been contaminated by a customer or coworker.

Restaurants that participate in this opportunity will receive a certificate honoring their commitment to protecting the health and safety of their workers and customers.

An employee at Steak ’n Shake in Columbia County reportedly tested positive for hepatitis A.

According to the Georgia Department of Public Health and East Central Health District, the employee is not currently working at the restaurant on Belair Frontage Road and coworkers have been offered the vaccination.

The department said the public has a low risk of being exposed to the virus from food service employees due to standard sanitation practices. Symptoms of hepatitis A include fever, fatigue, nausea, vomiting, diarrhea and abdominal pain and usually appear four weeks after exposure.

Environmental health staff are inspecting the restaurant to ensure safe food handling and preparation protocols are being followed, according to the department.

People who ate at the restaurant recently can talk to their health professional about receiving a vaccination.

The Franklin County Health Department is planning mass vaccinations after learning an employee who works at the Jack in the Box located at the Bourbeuse River Access in Union, Missouri had Hepatitis A while serving customers.

The Missouri Department of Health and Senior Services said the employee handled food on June 9 and June 10.

Hepatitis A  is a viral infection of the liver that can cause loss of appetite, nausea, tiredness, fever, and stomach pain. It’s usually spread when a person unknowingly ingests the virus from objects, food, or drinks that have been contaminated. Franklin County health officials have conducted several inspections of the Jack in the Box since the problem was discovered.

Health officials said it is uncommon for restaurant customers to become infected with Hepatitis A due to an infected food handler. However, anyone who consumed food or drinks at the restaurant on June 9 or June 10 is recommended to receive vaccination by June 23 as further protection from becoming ill.

Free vaccinations will be given out at the Franklin County Health Department headquarters at 414 East Main Street in Union on June 21 from 8 a.m. to 7 p.m. and June 22 from 8 a.m. to 1 p.m.