What can the 74 Hawaii victims do to help health officials? Be your own junior epidemiologist. Sitting in my hotel room on the shores of Waikiki in the remnants of tropical storm Darby, has given me time – perhaps too much – to think about this outbreak – especially after meeting with a few of the families. The Hawaii Department of Health (HDOH) is investigating a cluster of 74 hepatitis A infections on Oahu. Onset of illness has ranged between June 12 and July 14. Sick individuals were likely exposed to the fecal human virus through food, drink or personal exposure two to six weeks prior to the onset of symptoms – so the likely exposure period is May 1 through July 1. HDOH staff are conducting interviews with the cases in an effort to identify the source of infection. HDOH reports that identifying the source of infection continues to be a challenge because of the long incubation period of the disease and the difficulty patients have in accurately recalling the foods consumed and locations visited during the period when infection could have taken place. All of the cases are residents of Oahu with the exception of two individuals who now live on the islands of Hawaii and Maui, but were on Oahu during their exposure periods. On the 74 sickened, one was an employee of a Taco Bell on Oahu and one was an employee of a Baskin-Robbins on Oahu. They both worked prior to the onset of illness and during the peak exposure period. This has caused additional community concern that the outbreak may spread to Taco Bell and Baskin-Robbins patrons. So, what can the 74 outbreak victims do to help health officials find the common link? Here are some suggestions that I am sure HDOH officials are already using:
- Be cooperative – hepatitis A illnesses can last two to six months and victims are certainly not feeling their best, but their cooperation is vital.
- Think about what you ate or drank. That may well not be too productive – trying to recall what you ate or drank several weeks ago is difficult – I can hardly recall what I ate or drank a few days ago – however, try.
- Focus on where you have been eating and drinking in the two to six weeks prior to becoming ill – at home or out. Check your calendar, phone records and social media like Facebook and Twitter.
- Review your credit and debit card purchases as well as any accounts you have at grocery stores or restaurants.
- Ask friends, co-workers or family what they might recall that you did during that same time.
- Keep in contact with HDOH. Its resources are stretched and it needs your support and assistance.
With the help of the 74 – hopefully, not more – HDOH will solve this mystery and stop the spread of this potentially deadly virus. Disease Outbreak Control Division 1250 Punchbowl Street, Room 443 Honolulu, HI 96813 Tel: (808) 587-6845 Fax: (808) 586-8347 Disease Investigation Branch Tel: (808) 586-8362 Toll free: 1-800-360-2575 Fax: (808) 586-4595 (To sign up for a free subscription to Food Safety News, click here.)