The confirmed case count in Hawaii’s ongoing Hepatitis A outbreak is now 168, according to the most recent update from the Hawaii State Department of Health. That is an increase of 33 new cases since the last update on Aug. 3. The department’s Disease Outbreak Control Division reported that all cases of Hepatitis A illnesses so far have been in adults, and that 46 of those sickened required hospitalization, an increase of seven since the previous update. “Findings of the investigation suggest that the source of the outbreak is focused on Oahu. Eight individuals now live on the islands of Hawaii, Kauai, and Maui, and one visitor has returned to the mainland,” the department stated. Onset of the illnesses has ranged between June 12 and Aug. 1. The source of the outbreak has still not been found. “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,” department officials explained. Meanwhile, a worker at the Tamashiro Market in Honolulu reportedly tested positive for the virus, and the business decided to close for a few days while its employees received vaccinations. Also, the Hawaii Medical Assurance Association and the Hawaii Restaurant Association have joined efforts to get more workers vaccinated for Hepatitis A. Aug. 3 update: There are now 135 confirmed Hepatitis A cases in Hawaii, according to the latest update posted Wednesday by the Hawaii State Department of Health. That total is 42 more cases than the most recent update posted last week. All the confirmed Hepatitis A cases associated with this outbreak have been in adults, and 39 of them have required hospitalization, the department stated. Onset of illness has ranged between June 12 and July 24, 2016. “Findings of the investigation suggest that the source of the outbreak is focused on Oahu. Seven (7) individuals now live on the islands of Hawaii, Kauai, and Maui, and one visitor has returned to the mainland,” according to the announcement. Previous coverage follows: Victims of the ongoing Hepatitis A outbreak in Hawaii now include a food service employee at Chili’s restaurant on Oahu and a Hawaiian Airlines flight attendant, the Hawaii State Department of Health announced. Nearly 100 people have been sickened in this outbreak so far, which began in June and is centered on Oahu, although there are victims who visited there but are living on neighbor islands. The department posted the dates of potential exposure at the Chili’s outlet at 590 Farrington Highway in Kapolei and from the Hawaiian Airlines flight list. State Epidemiologist Dr. Sarah Park reiterated that no infections have been linked to possible exposure at Chili’s or Hawaiian Airlines and that the two companies are not being considered sources of the outbreak. “We are alerting the public only as a precaution; the risk of transmission is extremely low and these businesses are working with us to help prevent potentially new cases in our community,” she said. The department noted that although it is not a food service establishment, Hawaiian Airlines has been named because the infected crew member served inflight food and beverages to passengers. The airline has posted information about the situation here and advised the public that it will reimburse “reasonable out-of-pocket expenses upon submission of documentation” for any customer on the affected flights who, after consulting a medical provider, needs screening and/or vaccination for Hepatitis A. The reimbursement request must be submitted by Sept. 30. “We have had no other reported cases among staff and are proactively screening all crew who worked with this crewmember before they return to duty,” the airline stated. Park cautioned that people exposed to the virus can transmit it even if they’re unaware they have it. “The most infectious period for this disease may be as much as two weeks before the onset of symptoms — before the individual even knows he or she is sick,” she said. The department has also identified confirmed Hepatitis A cases among workers at Baskin-Robbins, Cosco Bakery, Sushi Shiono and Taco Bell. All are on Oahu except for Sushi Shiono, which is north of Kailua-Kona on the Big Island of Hawaii. According to a Wednesday news report, 24 employees of Sushi Shiono were tested for Hepatitis A and all results were negative. The worker who tested positive is believed to have contracted the virus while on Oahu. Anyone who consumed food or beverage products from the named businesses during the identified periods may have been exposed to the disease, the health department stated. They are advised to:
- Contact their healthcare providers about the possibility of receiving Hepatitis A vaccine or immune globulin (IG), which may provide some protection against the disease if administered within two weeks after exposure.
- Monitor their health for symptoms of Hepatitis A infection up to 50 days after exposure.
- Wash their hands frequently and thoroughly with soap and warm water, especially after using the bathroom or changing a diaper, and before preparing food.
- Stay at home and contact their healthcare provider immediately if symptoms of Hepatitis A infection develop.
The health department stated that to help prevent the spread of disease during the investigation, the public is encouraged to talk to their healthcare providers about vaccination. A statewide list of vaccinating pharmacies is available here, or people in Hawaii can call the Aloha United Way information and referral line at 2-1-1. Symptoms of Hepatitis A infection include fever, fatigue, loss of appetite, abdominal discomfort, dark urine, diarrhea, and yellow skin and eyes. Individuals, including food service employees, exhibiting symptoms of Hepatitis A should stay home and contact their healthcare provider. Additional information about Hepatitis A can be found here and here.
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