Public Health England is investigating an outbreak of Hepatitis A linked to food eaten at a school canteen. A total of 17 people with Hepatitis A have been confirmed connected to Outwood Academy in Ripon, a city in North Yorkshire.

Three other people have Hepatitis A in the Ripon area, but the source of illness for these patients remains under investigation.

At least two staff members at the school were confirmed with Hepatitis A infections. The school was not advised to close. Public Health England (PHE) is reviewing data about food eaten in the school canteen to find the source of the outbreak.

Both PHE and Harrogate Borough Council have the responsibility to investigate and manage outbreaks of infection to protect public health and ensure any necessary action is taken to prevent such incidents occurring in the future, according to regulations.

As a precaution, the academy canteen served only hot food in the past week and so far this week. The academy’s kitchens received a five star rating in March this year as part of an unannounced inspection, according to a letter from the school that was sent to parents.

Hepatitis A is a viral infection which affects the liver. It is passed from person to person by eating food or drinking water contaminated with the virus. To reduce the spread of the illness, it is important to wash hands after going to the toilet, before preparing or serving food, and before eating or drinking, according to PHE.

Anyone with suspected hepatitis A infection should not attend school or work until their doctor advises them to return. This is usually for one week, added the agency.

Further cases possible
Simon Padfield, consultant in Communicable Disease Control at PHE Yorkshire and the Humber, said laboratory testing confirmed the connection with the school.

“Investigations remain ongoing with our partners, but our findings to date suggest that hepatitis A infection may have been passed through food eaten at the school canteen. The school has been advised on measures to reduce any further risk, including enhanced deep-cleaning, enhanced hand washing and as an additional precaution, the school has stopped serving cold food for this week,” he said.

“We are also investigating an additional three cases of hepatitis A confirmed in the Ripon area. The source of illness for these cases remains under investigation, and it is not yet known if they are linked to the outbreak connected with the school. Any health risk continues to be low.”

Symptoms usually develop around four weeks after being infected and include mild fever, joint and muscle pain, feeling and being sick, diarrhea, loss of appetite and stomach pain. This can be followed by dark-colored urine, itchy skin and yellowing of the skin and whites of the eyes, which is called jaundice.

Padfield said the infected people experienced symptoms from June 11 to 20. it can take up to 50 days for symptoms of hepatitis A to develop. Some infected people show no symptoms but they can pass the virus to others by direct contact and by unknowingly contaminating foods and beverages.

“Reports of new cases of illness are now beginning to show signs of slowing down, although laboratory testing of further possible cases continues and so additional cases may be confirmed in the following weeks,” he said.

“GPs in North Yorkshire have been asked to remain vigilant to further cases. Families and staff at the school have been updated on our investigations and the measures put in place and have been asked to follow strict hand hygiene measures to prevent any person to person spread.”

Hepatitis A in Wales
Meanwhile, Public Health Wales is investigating an outbreak of seven confirmed cases of hepatitis A in the Vale of Glamorgan.

Previously, a cluster of five infected people had led to vaccination sessions in schools in Penarth and Barry. The two new patients are not students at either of the schools. But, both have direct links to the original five patients.

Public Health Wales, Cardiff and Vale University Health Board and the environmental health team at Shared Regulatory Services (SRS) Wales are investigating the outbreak.

“All of the patients confirmed with hepatitis A can be linked to one another, and there is no evidence of a wider public health risk at this time,” said Rhianwen Stiff, consultant in Communicable Disease Control for Public Health Wales.

“Hepatitis A can be unpleasant, but it’s not usually serious and most people make a full recovery within a couple of months. Children often only have a very mild illness or do not have symptoms at all. The best way to prevent infection spreading is to encourage good hand washing at all times, particularly after using the toilet and before preparing or eating food.”

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