Sept. 14 update: The Hawaii State Department of Health has identified 19 new cases of Hepatitis A since the most recent update a week ago. The total number of confirmed cases as of Wednesday is 271. All of those sickened in this outbreak have been adults, and 68 of them have required hospitalization, according to the department. Illness onset has ranged between June 12 and Sept. 4. The source of the outbreak continues to be focused on Oahu, 10 individuals are residents of Hawaii, Kauai, or Maui, and four visitors have returned to the mainland, the department added. Previous coverage follows: New victims in the Hawaii Hepatitis A outbreak linked to frozen, imported scallops continue to be identified, with the case count hitting 252 as of Wednesday. More than one-quarter of those people, 66, have had symptoms so severe that they required hospitalization, according to the weekly update from the Hawaii State Department of Health. The outbreak continues to be limited to adults only, with all but four of the victims being residents of Hawaii. HepatitisAMainHealth officials expect the count to continue to increase, even though the likely source of the outbreak — frozen scallops harvested and packed in the Philippines in November 2015 — was embargoed Aug. 15. That same evening, state officials ordered all Genki Sushi restaurants on Oahu and Kauai, which had been serving the scallops raw, to close for cleaning and sanitization. The long incubation period of the Hepatitis A virus, which usually doesn’t result in symptoms showing up for 15 to 50 days after exposure, made it difficult for public health investigators to identify the source of the outbreak. Illness onset dates for the outbreak began June 12, with the most recent person becoming ill on Aug. 30. Although no cases have been linked to restaurant employees at Genki Sushi or other restaurants, the health department has been closely monitoring the outbreak victims and alerting the public when anyone who works in foodservice is identified as a victim. During the Labor Day holiday weekend, an employee of Zippy’s Restaurant at 950 Kamokila Blvd. in Kapolei was confirmed as infected. The person worked evenings and nights in the sit-down dining section and bakery at Zippy’s, but did not work at the fast-food window, on Aug. 14, 18, 19, 21, 23, 25 and 26. The employee could have unknowingly exposed Zippy’s patrons during that time. “This case is a reminder that even though contaminated scallops have been removed from the market, the long Hepatitis A incubation period means we must continue to remain vigilant for new cases,” said Hawaii’s State Epidemiologist Sarah Park in a news release. The likelihood that patrons of this business will become infected is very low, according to the news release. Most people do not get sick when an employee at a restaurant has Hepatitis A. However, if an infected food handler is infectious and has poor hygiene, the risk goes up for patrons of that restaurant. Post-exposure injections of Hepatitis A vaccine or immune globulin are effective, but only if administered within two weeks of exposure. Anyone who believes they have been exposed to the virus is strongly encouraged to discuss post-exposure treatment with their doctors. For additional details on the outbreak, please see:

(To sign up for a free subscription to Food Safety News, click here.)