Since April 15, Public Health for Seattle and King County, WA, has learned of three people from three separate meal parties becoming ill with jaundice, abdominal pain, nausea, vomiting, fever, and fatigue after consuming food from the Señor Moose restaurant between Feb. 24 and 26.

There is no indication that any current employees of the restaurant have had illnesses consistent with hepatitis A symptoms. Public Health is also contacting former employees to find out if any of them have been ill.

The restaurant, at 5242 Leary Ave. NW, in Seattle, has a current food safety rating of “Good.”

This outbreak, which involves the hospitalization of one person, is occurring while the Seattle-King County area is experiencing an outbreak of hepatitis A, mostly among the homeless. Washington State last July declared a statewide hepatitis A outbreak among people who are homeless or using drugs.

More recently the Ballard area, where the restaurant is located, has had a cluster of hepatitis A cases among people living on the streets. None of the three cases associated with the restaurant, however, reported having any connection with the homeless or people using drugs.

Genetic testing of the three cases from the Moose restaurant is pending at the federal Centers for Disease Control and Prevention in Atlanta.

The Seattle area public health’s initial outreach to the restaurant was conducted by phone because of the ongoing response to the COVID-19 pandemic. Health investigators and restaurant management held a teleconference on April 17.  Investigators reviewed food handling practices, illness policies, employee schedules, employee health, and facility cleaning, sanitizing and disinfection procedures with restaurant management to identify possible risk factors for the spread of hepatitis A.

The restaurant closed for cleaning and disinfection at 1:30 p.m., April 17.

Investigators interviewed all current employees about health history, job duties, and food handling practices and continue interviewing former employees who worked around the time customers became ill.

An Environmental Health investigator visited the restaurant on April 19 to review food handling practices at the establishment and to verify proper cleaning and disinfection was completed and all ready-to-eat foods were discarded.

Management and staff were reminded that if anyone worked while ill with hepatitis A, they are not allowed to work for at least seven days after the onset of jaundice and after they’ve been symptom-free for 24 hours to be sure they are no longer contagious.

Señor Moose was allowed to re-open on April 20. Public health officials are working with management to see that all employees are vaccinated for hepatitis A.

Illness policy and food safety techniques were presented to employees before the re-opening. Surveillance for additional cases is ongoing.

Since July 2019, Washington State has recorded 297 confirmed hepatitis A cases that have resulted in 166 hospitalizations and five deaths.

“The populations most impacted by hepatitis A in Washington State include those who are unsheltered, using drugs (injection or non-injection), and those who are currently or recently incarcerated,” the CDC reports. ” Lack of access to clean water and hygiene opportunities is contributing to the spread of hepatitis A in Washington, which may be worsened with loss of access to bathrooms due to closures of libraries, restaurants, and other locations.”

The CDC says 17 counties in Washington State have been impacted by hepatitis A since April 1, 2019. The urban counties of King, Snohomish, and Spokane have been hit especially hard.

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