Hawaii health officials are asking for continued federal help with their investigation of a Hepatitis A outbreak traced to frozen, imported scallops served by Genki Sushi restaurants on Oahu and Kauai. Questions about possible wider distribution of the scallops were resolved late Tuesday when Department of Health (DOH) officials confirmed Honolulu-based distributor True World Foods did not send the scallops to Maui and Big Island locations. “DOH health inspectors were able to embargo the product at the True World Food warehouse on Oahu before it was distributed,” department spokeswoman Janice S. Okubo told Food Safety News. “The product of concern (is) Sea Port Bay Scallops — Wild Harvest, Raw Frozen — that originated in the Philippines (and) states ‘Product of the Philippines’ on the box, distributed by Koha Oriental Foods on Oahu and Kauai.” The outbreak appears to be restricted to Hawaii. One of the 168 victims is a resident of the mainland who recently visited Hawaii. Forty-six of the victims have required hospitalization. All of the victims are adults. The first was exposed in mid-April. “The DNA sequencing conducted by CDC showed the strain of Hepatitis A was only active in Hawaii and not reported in other states,” Okubo said. Earlier Tuesday, during a news conference to alert the public of the outbreak connection to Genki Sushi restaurants, State Epidemiologist Sarah Park warned that the 50-day incubation period of Hepatitis A means more people are expected to become ill. Park urged anyone who ate at a Genki Sushi restaurant on Oahu or Kauai in the past month to monitor their health for symptoms of Hepatitis A for at least 50 days after the date of exposure. Anyone who ate at one of the implicated Genki Sushi locations in the past two weeks should immediately talk with their doctor about receiving a post-exposure vaccination. The post-exposure injections must be given within two weeks of exposure. A list of pharmacies that have the post-exposure injections is available on the state health department’s website. Investigation to continue State officials said they had been looking closely at Genki Sushi restaurants as a possible common denominator among outbreak victims for about a week, but were not sure until Monday evening. “Because the Genki Sushi restaurants on Oahu and Kauai had received, handled and served the product, they were ordered to close immediately,” said Peter Oshiro, sanitation branch chief for the Hawaii health department.

Officials with the restaurant chain have been completely cooperative, Oshiro said during the Tuesday news conference. Genki Sushi USA’s chief administrative officer Mary Hansen said that cooperation will continue. The restaurants on Oahu and Kauai will remain closed until food and other potentially contaminated items have been disposed of and each location has been cleaned and sanitized, Oshiro said. Training for employees regarding hand-washing requirements and other food safety measures will also be required before individual locations are allowed to reopen. It likely would have taken two to three more weeks to confirm the link to Genki Sushi restaurants if the state had not received federal assistance, Park said. Staff from the Centers for Disease Control and Prevention arrived “when we needed help right now,” she said, but added that her staff still needs federal help to finish the investigation. It is as crucial to interview people who ate at Genki Sushi and did not become sick as it is to interview those who did, Park said, to determine if there is another possible source. More than 5,300 people have already responded to a state survey in relation to the Hepatitis A outbreak and Park said she hopes more participate. All of those responses must be investigated. Only about 70 percent of the confirmed victims reported eating at Genki Sushi restaurants, the other 30 percent either did not eat there or do not remember if they ate there before becoming infected. “We are negotiating with them (the Centers for Disease Control and Prevention) to allow staff to stay and help,” Park said Tuesday during the news conference. A CDC spokeswoman told Food Safety News Tuesday evening that the agency is continuing to investigate, but she did not specify how long federal staff would be on the ground in Hawaii. CDC began assisting with the investigation in July. The U.S. Food and Drug Administration is also involved in the investigation because of the source of the scallops is outside Hawaii, but few details were available Tuesday afternoon. “FDA and CDC are supporting the state of Hawaii, which is leading this investigation,” an FDA spokeswoman told Food Safety News. “FDA is still conducting traceback to where these products may have gone and how they may have been used, i.e. cooked or raw. More information will be shared when it becomes available.” Genki Sushi also has locations in Santa Ana, CA, and King County in Washington. Employees and a manager for the two Washington locations said Tuesday their scallops are supplied by a different vendor than the Hawaii locations. Orange County, CA, health officials visited the Genki Sushi location there Tuesday afternoon “to assess if they were aware of the recent outbreak in Hawaii and to verify their source for scallops,” spokeswoman Jessica Good said. “The restaurant operator was aware and is no longer offering scallops as part of their menu choices.” (To sign up for a free subscription to Food Safety News, click here.)