Maine Center for Disease Control and Prevention (Maine CDC) identified additional cases of acute hepatitis A virus infection in Aroostook County. Close contacts at risk are already being notified. The only risk to the public identified by Maine CDC at this time involves a Presque Isle food service worker.

The Presque Isle case served food and drink while infectious on May 26, 2019 and June 2, 2019.

Maine CDC recommends the hepatitis A vaccine as post-exposure prophylaxis to anyone who ate or worked at the Mai Tai Restaurant in Presque Isle, Maine between 11:00am and 4:30pm on June 2, 2019. Exposed persons can receive post-exposure prophylaxis up to 14 days from exposure, after which the treatment is no longer effective. Anyone who visited the restaurant between 11:00am and 4:30pm on May 26, 2019 is outside the window for which prophylaxis is recommended, but they should watch for symptoms and seek medical attention should they develop symptoms.

Health care providers are encouraged to remain vigilant for hepatitis A infection in persons with consistent symptoms. All cases of hepatitis are reportable in Maine. Providers with suspected cases should report them to Maine CDC at 1-800-821-5821.

People who ate at a local Taco Bell in mid-April may have been exposed to hepatitis A.

An employee at Taco Bell on 40976 U.S. Highway 19 North in Tarpon Springs tested positive for Hepatitis A, according to an email sent by the Pinellas County Health Department to the state.

The county also reported the employee worked at that Tarpon Spring’s Taco Bell during his infectious period from April 12 to April 14.

On April 17, the agency reached out to the Division of Hotels and Restaurants to conduct a joint investigation and food safety inspection.

When inspectors showed up on that day, the state found employees were not washing their hands.

According to the inspection report, the state also discovered there was no hot water in the hand wash sink in the men’s and women’s rooms and the soap dispenser was not working in the men’s room.

As health officials have warned, hepatitis A is spread when infected individuals do not wash their hands properly and contaminate food or surfaces they touch.

If you think you’ve been exposed to hepatitis A, medical experts recommend you get vaccinated as soon as possible.

The Pinellas County Health Department is offering free vaccines to anyone who wants one but the agency never told the public about the infected worker at Taco Bell.

A worker at a country club in Spring Hill may have exposed people, including high school students, to hepatitis A.

The Department of Health in Hernando County says someone working in food service at the Silverthorn Country Club Restaurant has tested positive for the disease.

Both Central and Springstead High Schools may have had their proms at Silverthorn during the dates in question, according to the school’s Facebook pages.

A vaccine can help protect you if you get it within two weeks and the health department is recommending anyone who ate or drank there during those dates should get one.

DOH-Hernando is also offering the hepatitis A vaccine for free at the Spring Hill location of the Health Department with extended hours May 1-3 and May 6-8 until 7 p.m.

From 2018 through May 1, 2019, there have been 41 confirmed cases of hepatitis A. In Hillsborough, there have been 165 cases. Pasco has reported 267 cases and Pinellas County has seen 319 cases.

Officials in Hernando County said 128 people came to get vaccinated at the health department after the Silverthorn case was announced.

Doctors suggest getting the vaccine if people exhibit the following symptoms: fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, light-colored stools, joint pain, and jaundice, reports the Centers for Disease Control and Prevention.

The Florida Department of Health said a restaurant worker in Clearwater has tested positive for hepatitis A. Now they are encouraging anyone who visited the Arby’s location to get vaccinated due to possible exposure.

A food service worker at the Arby’s restaurant, located at 30263 U.S. Highway 19 N, tested positive for the highly contagious disease, according to the Florida Department of Health in Pinellas County.

Health officials said the individual worked at the restaurant between April 5 and April 20 and may have been infectious.

Anyone who visited the restaurant during that period of time should get the hepatitis A vaccination. Those who have previously received the vaccine do not need another one.

The Department of Health said the vaccine may provide protection against the disease if given within two weeks after exposure.

Symptoms of hepatitis A include jaundice (yellowing skin and whites of eyes), fever, diarrhea, fatigue, loss of appetite, nausea and vomiting, stomach pain, dark-colored urine, or pale or clay-colored stool.

A special hepatitis A vaccination clinic will be open at the Department of Health’s Clearwater location at 310 N Myrtle Ave. on Friday, May 3 until 7 p.m. and on Saturday, May 4, from 8 a.m. to 2 p.m.

The Department of Health said it will continue to offer the hepatitis A vaccine at no cost and without an appointment at the following clinic locations on weekdays from 8 a.m. to 5 p.m.:

-St. Petersburg: 205 Dr. Martin Luther King Jr. St. N
-Pinellas Park: 6350 76th Ave. N
-Mid-County (Largo): 8751 Ulmerton Rd
-Clearwater: 310 N. Myrtle Ave
-Tarpon Springs: 301 S. Disston Ave

For goodness sake – vaccinate.

A case of hepatitis A has been diagnosed in an employee who handled food at Popeyes Louisiana Kitchen located at 7777 Burlington Pike, Florence, Kentucky (within the T/A Truck stop facility).  An ongoing investigation of the facility found that this employee worked during a period of time when ill or infectious, which included the dates of March 17 through April 5.

While it is relatively uncommon for restaurant patrons to become infected with the hepatitis A virus due to an infected food handler, anyone who consumed food or drink at Popeyes Louisiana Kitchen during the dates listed is recommended to receive a vaccination if it is within two (2) weeks of exposure as protection from becoming ill.  If it was during the dates listed but it has been longer than two weeks since the specific time you were there, it is recommended that you still get the vaccination although it will be outside the window to protect you from contracting the illness if you were exposed at this establishment.

Anyone who consumed food or drink at this Popeyes during the stated time period should monitor their health for symptoms of hepatitis A infection up to 50 days after exposure; wash their hands with soap and warm water frequently and thoroughly, especially after using the bathroom and before preparing food; and stay at home and contact their healthcare provider immediately if symptoms of hepatitis A infection develop.

The establishment’s management is cooperating with the investigation and response activities.  It has implemented enhanced disinfection steps to address surfaces that may have been contaminated.  Employees who worked with the involved employee have been informed to get hepatitis A vaccination to protect against the virus.  Co-workers have a greater risk of exposure due to prolonged close contact with the case.  Vaccination of associated food service workers helps to protect them against infection, which further protects the public.  Handwashing and related hygienic practices have been reinforced with the restaurant management and employees.  Additionally, the Health Department has directed restaurant employees to self-monitor for any symptoms of Hepatitis A that may develop over the next 50 days.

Hepatitis A is a viral infection of the liver that can cause loss of appetite, nausea, tiredness, fever, stomach pain, brown colored urine, light colored stools and diarrhea.  Yellowing of the skin or eyes (jaundice) may also appear.  People may have some or none of these symptoms.  It could take up to 7 weeks after being exposed to the virus for someone to become ill.  Children often do not exhibit symptoms.  Any person who believes they may have symptoms of hepatitis A should contact their healthcare provider.  Additional information regarding Hepatitis A can be found at nkyhealth.org.

Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person. The virus spreads when an infected person does not wash his/her hands adequately after using the toilet or engages in behaviors that increase risk of infection.  Careful hand washing, including under the fingernails, with soap and water, along with vaccination of anyone at risk of infection, will help prevent the spread of this disease.

New cases of hepatitis A have been trending downward over the past couple of months as local steps to control the outbreak have been making an impact.   However, Kentucky is still experiencing a hepatitis A outbreak.  Northern Kentucky has experienced 299 cases of hepatitis A in the outbreak thus far while Kentucky has experienced 4,381 cases.

As a result, the Northern Kentucky Health Department continues to encourage hepatitis A vaccination for the general public to protect against contracting the illness from any source of exposure.  Hepatitis A vaccine is given in two doses, six months apart. The first shot provides short-term protection and the second shot provides long-term protection. Although the vaccine is available at most doctor’s offices, pharmacies, and retail clinics, people should speak with their healthcare provider about wanting to get vaccinated. People with health insurance or Medicaid should be able to get the vaccine for free, but are recommended to check with their health insurance provider for coverage information.  NKY Health can also provide the vaccine at the county health centers to those on Medicaid, and on a sliding fee scale to those who do not have insurance, as well as those who have insurance that does not cover the vaccine.

For anyone who ate at the Western Sizzlin Restaurant in Ooltewah TN, around the time of March 10-20, 2019, they are advised to get their hepatitis A vaccine. The health department confirms that an employee of the restaurant worked during that time period in a food handling role while contagious with hepatitis A. Special vaccination clinics are being offered at 3rd Street, Sunday 3/24 1-6PM, Monday 3/25 8AM-6PM, and Tuesday 3/26 8AM-6PM, and at the Ooltewah health center Monday 3/25 8AM-6PM, and Tuesday 3/26 8AM-6PM. Additional protective measures, such as immune globulin injections, may be indicated for some people. For more information read below, or if you have any questions, please call the Epidemiology section at 423-209-8190.

The current number of cases (above) is significant because normally about 0 to 1 cases are reported to our Epidemiology section each year. We have to view this in light of the fact that both Middle Tennessee and other states around the country (Arkansas, California, Indiana, Kentucky, Michigan, Missouri, Ohio, Utah, and West Virginia) are experiencing outbreaks of hepatitis A. The Chattanooga-Hamilton County Health Department’s objective at this point in time is to take action to prevent the spread of the disease locally. Hepatitis A is vaccine-preventable and washing one’s hands before eating, preparing food and drink, or after changing diapers is one of the best ways to protect oneself.

Hepatitis A is a vaccine-preventable, communicable disease of the liver caused by the hepatitis A virus (HAV). It is usually transmitted person-to-person through the fecal-oral route or consumption of contaminated food or water. Hepatitis A is a self-limited disease that does not result in chronic infection.
What are the symptoms?

Most adults with hepatitis A have symptoms, including fatigue, low appetite, stomach pain, nausea, and jaundice, that usually resolve within 2 months of infection; most children less than 6 years of age do not have symptoms or have an unrecognized infection.
What are the major risk factors?

Those considered at high risk for hepatitis A infection in the larger Middle Tennessee outbreak include:

  • People who abuse drugs
  • People experiencing homelessness, and
  • Men who have sex with men.

Get the safe and effective hepatitis A vaccine, available from any of our clinics for free to those who are in the high risk groups.

Wash hands frequently and thoroughly before eating, before preparing food or drinks, and after changing diapers.

Avoid recreational drug use.

Using appropriate protection during sex.

How serious is this disease?

The disease can be mild in most people, serious in some, and can result in hospitalization or death. During a similar outbreak in San Diego County, California, from September 1, 2017, to January 23, 2018, 589 cases were reported with 404 (68.6%) hospitalizations and 20 (3.4%) deaths. Notably, this outbreak has had a high hospitalization rate among those infected with hepatitis A.

On August 15, 2016, the Hawaii Department of Health (HDOH) identified raw scallops served at Genki Sushi restaurants on Oahu and Kauai as a likely source of an ongoing hepatitis A outbreak. The product of concern was identified to be Sea Port Bay Scallops (Wild Harvest, Raw Frozen) that originated in the Philippines (states “Product of the Philippines” on the box) and were distributed by Koha Oriental Foods.

As a result, HDOH ordered this product embargoed (not to be sold, purchased, or consumed) throughout the state, and the temporary closure of all Genki Sushi restaurants on Oahu and Kauai.

As of November 30, 2016, HDOH has identified 292 cases of hepatitis A. Seventy-four have required hospitalization. Findings of the investigation suggest that the source of the outbreak is focused on Oahu. Eleven individuals are residents of the islands of Hawaii, Kauai, or Maui, and seven visitors have returned to the mainland or overseas. Onset of illness has ranged between June 12, 2016 and October 9, 2016.

The FDA and CDC are supporting the HDOH in the investigation of hepatitis A virus (HAV) infections linked to scallops supplied by Sea Port Products Corp. On August 17, 2016, the FDA, HDOH, CDC, and state partners informed Sea Port Products Corp. that epidemiological, laboratory, and traceback information indicated that their scallops are the likely source of illnesses. On August 18, 2016, Sea Port Products Corp. initiated a voluntary recall of three lots of frozen Bay Scallops produced on November 23 and 24, 2015. The lot numbers for the recalled scallops are 5885, 5886, and 5887. The products were distributed to California, Hawaii, and Nevada. According to Sea Port Products Corp., the recalled products are not intended for retail sale. The FDA is working with the recalling firm to ensure their recall is effective and that recalled product is removed from the market.

The FDA’s traceback investigation involved working with HDOH to trace the path of food eaten by those made ill back to a common source. The traceback investigation determined that Sea Port Products Corp. imported the scallops that were later supplied to certain Genki Sushi locations in Hawaii, where ill people reported eating.

On August 17, 2016, FDA laboratory analysis of two scallop samples, which were collected on August 11, 2016, were confirmed positive for hepatitis A. These samples were imported by Sea Port Products Corp. and were produced on November 23 and 24, 2015.

Beginning in September 2016, several states, the CDC, and the FDA investigated a several states, CDC, and the FDA investigated a multistate outbreak of foodborne hepatitis A. Epidemiologic and traceback evidence indicate that frozen strawberries imported from Egypt are the likely source of this outbreak. Although no discovery has been done to date to confirm how the Egyptian strawberries made it to consumers, we have learned that Tropical Smoothie had a bulk purchasing agreement with Patagonia. Patagonia bought from VLM Canada. It is also our understanding that VLM Canada bought from ICAPP and that VLM USA was the importer. It appears that the strawberries entered the US in Norfolk into VLM USA’s possession and then were transferred to Preferred Freezers Storage, Inc. in Chesapeake into Patagonia’s possession.  From there, ITI picked up the berries and delivered them to either Sysco Hampton Roads or Sysco VA.  Sysco delivered them to Tropical Smoothie franchisees.

Nearly all ill people interviewed reported drinking smoothies containing strawberries at Tropical Smoothie Café locations prior to August 8, in a limited geographical area, including Maryland, North Carolina, Virginia, and West Virginia, but there have been a small number of cases outside of that geographic area with no Tropical Smoothie Café exposure.

In total, 134 people with hepatitis A have been reported from nine states: Arkansas (1), California (1), Maryland (12), New York (3), North Carolina (1), Oregon (1), Virginia (107), West Virginia (7), and Wisconsin (1). Of these cases, 129 people reported eating a smoothie containing strawberries from a Tropical Smoothie Café, and five cases reported having no exposure to Tropical Smoothie Café. There have been no cases reporting illness from this same exposure since September 23, 2016. The latest illness onset date among these cases was October 1, 2016. The investigation into these cases is ongoing. Of the 134 cases, 52 ill people have been hospitalized, and no deaths have been reported.

FDA traceback information indicated that the frozen strawberries served in the Tropical Smoothie Café locations were from the International Company for Agricultural Production & Processing (ICAPP), imported from Egypt. 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. Information available at this time does not indicate an ongoing risk of hepatitis A virus infection at Tropical Smoothie Cafés.

On October 30, 2016, the International Company for Agricultural Production & Processing (ICAPP) recalled all of its frozen strawberries that were imported into the U.S. since January 1, 2016. The recalled products were distributed for sale to and use in food service establishments nationwide. The FDA reports that hepatitis A virus contamination was found in four samples of ICAPP frozen strawberries.

Erie County officials are urging anyone who recently ate at Destiny’s on Fillmore in Buffalo to be vaccinated for Hepatitis A after the virus was identified in a worker at the restaurant.

According to Erie County Executive Mark Poloncarz, anyone who at as a dine-in or takeout customer between February 27, 2019 and March 11, 2019 is eligible to recieve a free Hepatitis A vaccine provided by the Erie County Department of Health. The vaccine clinics will be held on March 13 and March 14, from 3 pm to 8pm, at the Elim Christian Fellowship located at 70 Chalmers Avenue in Buffalo.

Officials say people who ate at the restaurant between February 9 and February 26 may have been exposed but will “not benefit from Hepatitis A vaccine to prevent infection from this exposure.” Everyone is encouraged to monitor their health for symptoms for 50 days after consuming food from the establishment.

The Erie County Department of Health has provided the following information on Hepatitis A.
Symptoms of Hepatitis A can include:

• Fever
• Fatigue
• Loss of appetite
• Nausea
• Vomiting
• Abdominal pain
• Dark urine
• Clay-colored stools
• Joint pain
• Jaundice (yellowing of the skin and eyes)

• Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. It can range from no symptoms at all, to a mild illness lasting a few weeks, to a severe illness lasting several months. Although rare, hepatitis A can cause death in some people.
• Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person. This can happen from eating at a restaurant, sharing food or drink, or eating when traveling in one of the many countries outside the United States with a high Hepatitis A infection rate.
• People who are most at risk of Hepatitis A include:

– People with direct contact with someone who has a hepatitis A infection. This can occur up to 2 weeks before the infected person develops any symptoms, so you may not be aware of your exposure at the time.
– Travelers to countries where hepatitis A is common, which include most countries outside the United States. More information is available on the Centers for Disease Control and Prevention’s web site.
– Men who have sexual contact with men,
– People who use drugs, both injection and non-injection drugs, and
– Homeless individuals

People who are considered high risk for exposure to the Hepatitis A virus should get vaccinated as soon as possible to avoid contracting the virus and lessen the spread of the disease. High risk groups include individuals who use illicit drugs, close contacts of illicit drug users, and homeless people.

The Department for Public Health (DPH) is making this recommendation as part of its efforts to respond to the ongoing outbreak of Hepatitis A. Since the outbreak began in August 2017, reported cases continue to rise and have now been recorded in 103 of Kentucky’s 120 counties.

“If you are at-risk of exposure to the Hepatitis A virus, we urge to get vaccinated immediately. Immunizations can be obtained from a healthcare provider, pharmacies, and clinics throughout the state. Local health departments have limited vaccine supply for at-risk individuals who are uninsured,” said DPH Commissioner Dr. Jeff Howard. “In addition, if you live in a county currently experiencing an outbreak, we also urge you to be vaccinated for Hepatitis A as well as continue to practice regular and thorough hand washing, particularly if you are engaging with any of the high risk groups.”

About 80 percent of cases in the current outbreak are people in the high risk groups. Other priority populations include;

People with direct contact with someone who has Hepatitis A (particularly during their infectious period);
Men who have sexual contact with men; and
People who are at increased risk of complications from Hepatitis A (e.g., people with chronic liver disease).
As of Jan. 26, 3,819 cases have been reported in Kentucky due to the outbreak. A recent year-end review of Kentucky mortality records revealed additional deaths, increasing the total known deaths to 40 associated with the current Hepatitis A outbreak. Counties have reported 1,862 hospitalizations due to Hepatitis A.

To date, 80 counties have reported five or more cases, meaning they meet the threshold for what is considered an outbreak of Hepatitis A virus. Boyd, Carter, Fayette, Floyd, Jefferson, Kenton, Laurel, Madison, and Whitley counties report 100 or more cases associated with the outbreak.

Hepatitis A is a highly contagious, vaccine-preventable disease of the liver, which causes inflammation of the liver and affects the organ’s ability to function. Signs and symptoms of Hepatitis A include nausea, diarrhea, and loss of appetite, fever, fatigue, jaundice (yellowing of the skin or eyes), clay-colored bowel movements, dark-colored urine, and abdominal discomfort. Signs and symptoms usually appear 2-4 weeks after exposure, but may occur up to 7 weeks after exposure. Children under 6 years of age with Hepatitis A often show few signs and symptoms.

Hepatitis A virus is found in the stool of infected people, and is usually spread person-to-person when infected people do not properly wash their hands or do not have access to proper sanitation. Transmission typically occurs when a person ingests infected fecal matter, even in microscopic amounts, from contact with contaminated objects, food, or drinks. DPH recommends frequent hand washing, particularly after using the restroom, or before eating, to prevent transmission of hepatitis A and many other common diseases.

To prevent new cases from occurring, DPH has partnered with local public health staff, health care providers, correctional facilities, faith-based organizations, homeless shelters, and substance abuse treatment centers to vaccinate people who are at the highest risk of getting Hepatitis A. People who have had Hepatitis A disease or previously received 2 doses of the Hepatitis A vaccine do not need to be immunized.

“Vaccination of high risk groups is crucial to stopping the outbreak in Kentucky,” added Dr. Howard. “If you or someone you know might be at risk for Hepatitis A, please get vaccinated as soon as possible at your local health department, primary care physician’s office, or local pharmacy. If you suspect you might have Hepatitis A infection or are experiencing symptoms (including, vomiting, diarrhea, jaundice/yellowing of the skin and eyes), you should seek medical care immediately.”

Individuals also are advised to contact their local health department or the Reportable Disease program at DPH at (502) 564-3261.

Since 2006, the Centers for Disease Control and Prevention (CDC) has recommended that all children receive the Hepatitis A vaccine series. DPH recommends children aged 1 to 18 years receive the two-dose Hepatitis A vaccine, as well as at-risk adults. Kentucky now requires all students in kindergarten through 12th grade to have two doses of the Hepatitis A vaccine in order to attend school or receive a provisional certificate of immunization.