As the number of sick people in Hawaii’s Hepatitis A outbreak continues to increase, a seafood importer, a distributor and a sushi chain are facing a class action lawsuit — filed specifically on behalf of people who did not get sick.

The state health department reports confirmed outbreak cases reached 228 as of Wednesday afternoon, up 22 from a week ago. The number of people that could eventually be included in the class action is estimated at 10,000 or more by attorneys handling the lawsuit. Restaurant chain Genki Sushi, distributor Koha Foods and importer Sea Port Products Corp. are named as defendants in the lawsuit. It involves imported, frozen scallops that the Food and Drug Administration has found to be contaminated with the outbreak strain of the Hepatitis A virus.

“This is quickly becoming one of the largest Hepatitis A outbreaks in U.S. history. Given the number of people that consumed scallops at Genki Sushi and became ill and worked at other restaurants on the islands, we estimate that over 10,000 people needed to be vaccinated to prevent an even larger disaster,” said Bill Marler, a Seattle food safety attorney who joined with a Honolulu law firm to file the class action. Marler, founding partner of the Marler Clark law firm, and the Honolulu firm Starn O’Toole Marcus & Fisher are representing Bryan K. Cuelho, an Oahu resident who ate scallops and other food at the Waikele Genki Sushi restaurant on Aug. 6. Less than 10 days later, on Aug. 15, state health officials announced they had discovered a link between the scallops and outbreak victims. They advised that anyone who had eaten at a Genki Sushi restaurant “in the past two weeks” should consider receiving a post-exposure Hepatitis A vaccination or immune globulin (IG) shot. Cuelho followed the advice and sought post-exposure treatment. The civil suit filed Tuesday in Hawaii’s First Circuit Court seeks compensation for him and others for medical expenses, lost wages and other damages related to the post-exposure safety measures. “This is a class action lawsuit brought on behalf of all persons who were exposed, by consumption of adulterated food and drink, to the Hepatitis A virus, HAV, at the defendant Genki Sushi USA Inc.’s restaurants during the exposure period from April through August 2016,” according to the complaint. “The plaintiff and class-members were required for public health and personal safety reasons to obtain Hepatitis A vaccination or an IG shot — with some persons also getting an HAV blood test — because of their exposure at the defendant Genki Sushi USA Inc.’s restaurants.” In addition to recovering direct costs incurred by those who received post-exposure injections, the lawsuit is expected to raise public and corporate awareness about Hepatitis A vaccinations, which Marler has been advocating for all foodservice workers for several years. “As a premier tourist destination, we want Hawaii to have the highest standards in food safety so our guests feel secure. We also want our local people to be taken care of. This suit is a step toward that,” attorney Trevor Brown of Starn O’Toole Marcus & Fisher said in a news release after the civil case was filed.

Outbreak investigation ongoing The Hawaii Department of Health is continuing its investigation of the Hepatitis A outbreak, announcing Tuesday that a second Hawaiian Airlines employee is among the confirmed cases. Flight attendants and foodservice workers can potentially spread the virus to hundreds of people via foods and beverages and therefore are of particular concern to public health officials. “This case is a reminder that Hepatitis A symptoms can appear up to 50 days after exposure,” said State Epidemiologist Dr. Sarah Park. “This is why we expect to continue to see cases in coming weeks, and why we need to remain vigilant to prevent further transmission, even though the product has been pulled off the market.” A complete list of food service establishments who have had employees diagnosed with Hepatitis A infections and the flights that the two Hawaiian Airlines employees worked are available on the health department’s website. As of Wednesday’s update, 58 of the 228 outbreak victims have required hospitalization. All of the confirmed cases have been adults. The vast majority of victims are Oahu residents. Eleven are residents of the islands of Hawaii, Kauai or Maui, and three are visitors who have returned to the mainland. Onset of illness has ranged between June 12 and Aug. 16. Editor’s note: Bill Marler of the Marler Clark law firm is publisher of Food Safety News. (To sign up for a free subscription to Food Safety News, click here.)