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

The Taco Bell restaurant in Waipio at 94-790 Ukee St. where the infected employee works is less than a mile and a half from the Baskin-Robbins ice cream store at the Waikele Outlet Center. An employee at the Baskin-Robbins was announced last week as the first confirmed foodservice worker case in the outbreak that is believed to have begun June 16. “It is important to note that neither the Waikele Baskin-Robbins nor the Waipio Taco Bell have been identified as the source of infection for this outbreak,” said State Epidemiologist Dr. Sarah Park in a news release. “These are merely places where the victims were employed. The likelihood that patrons of these food establishments will become infected is very low, but to prevent possible additional cases, we are notifying the public so they may seek advice and help from their healthcare providers. “Additional food service establishments may be affected as the number of cases continues to grow. Individuals, including food service employees, exhibiting symptoms of Hepatitis A should stay home and contact their healthcare provider.” The health department is advising people who consumed any food or beverages at the Taco Bell recently that they may have been exposed to Hepatitis A and should therefore ask their doctors if they should consider receiving a shot of vaccine or immune globulin. The specific dates in question for Taco Bell customers are June 16, 17, 20, 21, 24, 25, 28, 29, 30, and July 1, 3, 4, 6, 7 and 11. “Unvaccinated individuals should contact their healthcare providers about the possibility of receiving hepatitis A vaccine or immune globulin, which may provide some protection against the disease if administered within the first two weeks after exposure,” according to the health department, which issued a similar notice last week after the Baskin-Robbins employee was confirmed as part of the outbreak. Possible exposure dates for customers of the Baskin-Robbins store are June 17, 18, 19, 21, 22, 25, 27, 30, and July 1 and 3. Updated numbers on confirmed cases are scheduled to be posted Wednesday, following weekly on Wednesdays until further notice, a spokeswoman at the state’s health department said Monday morning. When the health department announced the outbreak on July 1, there were 12 cases, with six having required hospitalization. As of last week’s update, there were 52 confirmed cases. All confirmed cases are on Oahu and involve adults. Sixteen have had symptoms so severe that they required hospitalization. “Symptoms of Hepatitis A infection include fever, fatigue, loss of appetite, abdominal discomfort, dark urine, diarrhea and yellow skin and eyes, and typically last several weeks to as long as two months,” according to the health department. “Treatment of Hepatitis A is supportive, and most people will recover without complications. While vaccination provides the best protection, frequent hand washing with soap and warm water after using the bathroom, changing a diaper and before preparing food can help prevent the spread of Hepatitis A. Appropriately cooking foods can also help prevent infection.” For a list of vaccinating pharmacies, call the Aloha United Way information and referral line at 2-1-1 or visit http://health.hawaii.gov/docd/files/2013/07/IMM_Adult_Resource_List.pdf. Additional information about Hepatitis A can be found on the Hawaii Department of Health website. (To sign up for a free subscription to Food Safety News, click here.)