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. 
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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