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Biological Health Hazard – Hepatitis A (HAV) Outbreak (public health threat): Waipahu, Oahu, Hawaii


Published Date: 2016-07-13 15:23:58
Subject: PRO/EDR> Hepatitis A – USA (05): (HI)
Archive Number: 20160713.4342961

Update: Tuesday, 19 July 2016
Food Safety News
Second restaurant worker confirmed in Hep A outbreak

An employee of a Taco Bell on Oahu has been confirmed as the second food service worker included among the 52 victims of a Hepatitis A outbreak that Hawaii’s health officials expect to grow.

Tuesday, 12 Jul 2016
Source: State of Reform [edited]

The number of known cases of Hepatitis A on Oahu has risen to 52 after the Hawaii Department of Health (DOH) confirmed that a food worker at a Baskin-Robins store at Waikele Center in Waipahu has the virus. The source of the growing outbreak has yet to be confirmed but health officials are advising people who may have consumed food at the store that they may have been exposed. Of the 52 confirmed cases of Hepatitis A, 16 have required hospitalization, according to DOH.

In a press release, DOH Health Director Virginia Pressler said the department is working to identify the source of the infection by questioning the infected individuals. She said they are also working with clinicians to ensure DOH is notified of any more cases. “Since people are contagious before they feel ill, we are very concerned about the disease unknowingly being [spread] to others,” Pressler said.

Finding the source of a hepatitis A outbreak can be difficult due to the nature of the infection. “Identifying the source of infection is a challenge,” Sarah Park, state epidemiologist and chief of DOH’s disease outbreak control division, said in the press release. “Hepatitis A has a long incubation period lasting anywhere from 2 weeks to as long as 50 days. Accurately recalling all of the foods consumed and locations visited during the period when infection could have taken place is challenging for many, especially those who are still feeling ill.”

Infections on Oahu would have occurred from 16 Jun 2016 through 27 Jun 2016 [it is unclear if this means that the cases presented then or are felt to have been acquired during this window – Mod.LL] , DOH said.”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,” Park said.

The hepatitis A vaccine is readily available at local pharmacies, DOH said. 2 doses of hepatitis A vaccine, given at least 6 months apart, are needed for lasting protection.

[Byline: Zack Hale]

Communicated by:
ProMED-mail from HealthMap Alerts

[There are likely many more cases that are subclinical (without symptoms) or anicteric (without jaundice). It is clear that the peak time for infectivity with hepatitis A is before symptoms occur when virus concentrations in the stool are at their highest. Whether the food worker at the ice cream store is the source is unclear as the worker could just be one of those infected but could serve as a source of secondary cases of the infection as individuals in household settings can. – Mod.LL

A HealthMap/ProMED-mail map can be accessed at:]

See Also

Hepatitis A – USA (04): (HI) RFI 20160707.4330783
Hepatitis A – USA (03): (HI) 20160703.4323888
Hepatitis A – USA (02): (PR) hospital workers 20160630.4314683
Hepatitis A – USA: (TX) nosocomial, 2015 20160428.4190053

Hepatitis A – USA (03): (NY) restaurant associated 20151213.3859789
Hepatitis A – USA (02): ex Mexico (QR) 20150503.3338598
Hepatitis A – USA: (NJ) restaurant-associated 20150102.3067761

A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases

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