Hawaii Hepatitis A Outbreak Linked to Genki Sushi Restaurants
On August 15, 2016, the Hawaii Department of Health (HDOH) identified raw scallops served at Genki Sushi restaurants on Oahu and Kauai as a likely source of an ongoing hepatitis A outbreak. The product of concern was identified to be Sea Port Bay Scallops (Wild Harvest, Raw Frozen) that originated in the Philippines (states “Product of the Philippines” on the box) and were distributed by Koha Oriental Foods.
As a result, HDOH ordered this product embargoed (not to be sold, purchased, or consumed) throughout the state, and the temporary closure of all Genki Sushi restaurants on Oahu and Kauai.
As of November 30, 2016, HDOH has identified 292 cases of hepatitis A. Seventy-four have required hospitalization. Findings of the investigation suggest that the source of the outbreak is focused on Oahu. Eleven individuals are residents of the islands of Hawaii, Kauai, or Maui, and seven visitors have returned to the mainland or overseas. Onset of illness has ranged between June 12, 2016 and October 9, 2016.
The FDA and CDC are supporting the HDOH in the investigation of hepatitis A virus (HAV) infections linked to scallops supplied by Sea Port Products Corp. On August 17, 2016, the FDA, HDOH, CDC, and state partners informed Sea Port Products Corp. that epidemiological, laboratory, and traceback information indicated that their scallops are the likely source of illnesses. On August 18, 2016, Sea Port Products Corp. initiated a voluntary recall of three lots of frozen Bay Scallops produced on November 23 and 24, 2015. The lot numbers for the recalled scallops are 5885, 5886, and 5887. The products were distributed to California, Hawaii, and Nevada. According to Sea Port Products Corp., the recalled products are not intended for retail sale. The FDA is working with the recalling firm to ensure their recall is effective and that recalled product is removed from the market.
The FDA’s traceback investigation involved working with HDOH to trace the path of food eaten by those made ill back to a common source. The traceback investigation determined that Sea Port Products Corp. imported the scallops that were later supplied to certain Genki Sushi locations in Hawaii, where ill people reported eating.
On August 17, 2016, FDA laboratory analysis of two scallop samples, which were collected on August 11, 2016, were confirmed positive for hepatitis A. These samples were imported by Sea Port Products Corp. and were produced on November 23 and 24, 2015.
While vaccination provides the best protection, frequent handwashing with soap and warm water after using the bathroom, changing a diaper, or before preparing food can help prevent the spread of hepatitis A. Appropriately cooking and preparing foods can also help prevent infection.
What is Hepatitis A?
Hepatitis A is a contagious liver infection caused by the hepatitis A virus (HAV). The disease can range from a mild illness lasting 1 or 2 weeks to a severe illness lasting for several months. HAV is found in the stool of people with hepatitis A infection and is usually spread by eating contaminated food or drinking water and can be spread through close personal/sexual contact. A person who has hepatitis A can easily pass the disease to others within the same household.
What are the symptoms of hepatitis A infection?
Not everyone has symptoms. If symptoms develop, they can include:
Light colored stools
Loss of appetite
Yellow skin and eyes (Jaundice—may develop several days to a week after other symptoms begin)
Infants and young children with hepatitis A infection tend to have milder or no symptoms and are less likely to develop jaundice than are older children and adults.
Illness usually occurs from two weeks to as long as 50 days after exposure to the hepatitis A virus (i.e., consuming the contaminated product).
Persons should seek medical attention immediately should they develop symptoms.
Who should be tested for hepatitis A infection?
Testing when you have no symptoms is not recommended: your test result may be negative because it is too early (given the long incubation period of hepatitis A disease)—that is, you may have a false negative result.
Only patients who have symptoms of hepatitis A infection should be tested.
How long is a person with hepatitis A contagious?
Patients with hepatitis A are most contagious during the 1 to 2 weeks before the symptoms start until at least 1 week after the start of first symptoms.
What is the treatment for hepatitis A infection?
There is no special treatment for persons with hepatitis A infection. Most persons with hepatitis A infection will recover without complications but may require supportive therapy (e.g. fluids orally or, in some cases, given through the vein, medicines to control fever) and close monitoring by their physician. Persons should seek medical attention if they develop symptoms of hepatitis A infection.
How can I prevent hepatitis A infection?
Hepatitis A infection is a vaccine preventable disease. Fortunately, most children and some adolescents have been vaccinated as part of routine and catch-up childhood vaccination recommendations. However, many adolescents and adults have not been vaccinated and will be susceptible.
Two doses of hepatitis A vaccine are needed for lasting protection. These doses should be given at least 6 months apart.
If you have already been vaccinated against hepatitis A or have had hepatitis A disease in the past, you should be protected and do not require a booster for protection.
Does hepatitis B vaccine provide any protection against hepatitis A?
Hepatitis A, hepatitis B, and hepatitis C are diseases caused by three different viruses. Although each can cause similar symptoms, they have different modes of transmission and can affect the liver differently. There are vaccines to prevent hepatitis A and B; however, there is not one for hepatitis C. Vaccination with hepatitis B vaccine does not provide protection against hepatitis A disease.