Officials in Hong Kong have issued a warning because of a rise in Hepatitis A cases since October.

The Centre for Health Protection (CHP) of the Department of Health reminded the public to maintain strict personal, food and environmental hygiene.

Twelve hepatitis A cases were reported to the CHP in October, higher than the one to five infections recorded per month from January through September this year. Two cases have been identified so far in November.

The 14 cases include eight men and six women with ages ranging from 9 years old to 54 years old.

A CHP spokesman said the center is closely monitoring the situation and investigations are ongoing.

“Our epidemiological investigations so far have not identified a common food or water source among these cases. There was also no epidemiological linkage identified among them,” he said.

“The CHP will update relevant non-governmental organizations of the latest situation of hepatitis A and its preventive measures and seek their support to strengthen health education and promotion among the Pakistani community.”

Hepatitis A virus is transmitted primarily by the fecal-oral route when an uninfected person has contact with or ingests food or water contaminated with visible or microscopic amounts of feces from an infected person. The virus can be transmitted by eating contaminated foods such as shellfish without thoroughly cooking it and drinking contaminated beverages.

Four of the outbreak patients had been in Pakistan before becoming ill. Three others identified themselves as Pakistanis. There is also one local case and two with the place of infection undetermined. No imported cases from Pakistan or involving Pakistanis were reported from January through September this year.

The remaining seven patients included five local, one who became infected in Bangladesh, and one with place of infection undetermined. All required hospitalization and were in a stable condition as publication of the public warning.

The CHP has recorded a total of 44 cases of hepatitis A in 2018. From 2013 to 2017,  there were 44, 46, 138, 98 and 117 infections recorded, respectively.

Hepatitis A is a liver disease caused by the hepatitis A virus (HAV). Symptoms can include fever, malaise, loss of appetite, diarrhea, nausea, abdominal discomfort, yellowing of the skin and eyes, dark urine and pale stool.

The average incubation time of HAV is 28 days, but it can take up to 50 days after exposure for symptoms to appear. An HAV-infected person can have the virus in their blood for up to six weeks through their clinical course and excrete it in their stool for up to two weeks before becoming symptomatic, making identifying exposures particularly difficult.

Adults have signs of illness more often than children and disease severity increases in older age groups. Recovery following infection can take several weeks or months.

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