It seems like Hawaii is not the only state having issues with Hepatitis A poisoning. Recently, state government officials detected an outbreak of Hepatitis A in Virginia. The Virginia Department of Health has reported that there are about 51 people sickened in the outbreak, and these people reside in over 5 different states. Most of the cases, 44 to be exact, originated in Virginia. There have also been four confirmed cases of Hepatitis poisoning in Maryland. North Carolina, Oregon, and Wisconsin have all reported 1 case of illness. Those sickened in the outbreak have reported illness onset dates between May and August, 2016. People sickened in Virginia range in age from 15 years to 68 years old. Roughly 50% of ill people required hospitalization.

The Virginia Department of Health has been investigating the outbreak since August 5, and has received help from federal investigators with the CDC and FDA. Although there were illnesses reported prior to August 5, health officials had not determined a link between the illnesses before August. After the August 5 outbreak discovery, health officials waited 2 weeks to alert the public of the outbreak, in order to allow more information to be available at the initial announcement of the outbreak. However, this decision may have prevented some people from obtaining the vaccination immediately after exposure to Hepatitis A. The Hepatitis A vaccine is even effective if it administered after exposure to the Hepatitis virus. The time-period for an after-exposure vaccination, however, is only two weeks.

State and local health officials were able to find a source of the outbreak in the course of their investigation. Using DNA fingerprinting technology, investigators were able to uncover that many of those sickened in the outbreak had a strain of Hepatitis A that is a close genetic relation to previous outbreaks. Investigators were able to decipher that frozen strawberries imported from Egypt caused the previous outbreaks. Many of those sickened in the outbreak, over the course of their interviews with health officials, reported drinking smoothies from Tropical Smoothie Cafe prior to becoming ill. With this information, investigators began to consider Tropical Smoothie Cafe the source of the outbreak. This suspicion was confirmed when health officials discovered that the Egyptian strawberries linked to the outbreak via DNA were used by Tropical Smoothie Cafe in their smoothies. The company has since removed the tainted products from use at all locations of Tropical Smoothie Cafe.

There has also been one reported case of Hepatitis A in an employee of Tropical Smoothie Cafe. Although the investigators do not consider this employee to be the source of the outbreak, days when a sick employee worked greatly increase the chance of the illness spreading. Health official have recommended that anyone who consumed smoothies at the Tropical Smoothie Cafe in Gainesville, Virginia should be on the lookout for the symptoms of Hepatitis poisoning. Those who visited that location on or after August 17 can still benefit from a vaccination, which is also highly recommended.

There are many ways to prevent a Hepatitis A infection from happening. Practicing good hygiene, including the thorough washing of hands, is important in halting the spread of infection. Those sickened with Hepatitis A should not prepare food for others, as the infection may spread. However, the best way to prevent a Hepatitis A infection is by getting a vaccination. The CDC recommends that anyone over the age of 1 year old receive the Hepatitis A vaccination. The vaccine is safe for all people to receive, and is administered through two shots given over a period of six months. The vaccine was first introduced in 1995, and had a tremendous effect on the incidence rates of Hepatitis A. In 1989, statistics reported almost 40,000 cases of Hepatitis A, but today the CDC estimates that there are less than 5,000 cases of Hepatitis A per year. Again, the CDC recommends that all children over the age of 1 receive the vaccination, as well as those traveling to areas with high incidence rates of Hepatitis A, those working in hospital and research facilities, and those with chronic liver diseases. If you have received a vaccine, even as a young child, the vaccine still protects you from infection.

The vaccine works by introducing inactivated Hepatitis A virus to a person’s body in order to spur the creation of antibodies. These antibodies represent the body’s natural immune response to the presence of the virus, and they work to identify a specific virus in the bloodstream, which activates the body’s immune response to destroy the virus. These antibodies also appear if Hepatitis A infects someone. Because Hepatitis A antibodies do not go away, someone who has previously been infected cannot be infected a second time, much like the chicken pox.

Hepatitis A infections may not produce symptoms in those it infects, depending on their age. Asymptomatic cases of Hepatitis A are most common in children under the age of 6, where about 70% of infections are asymptomatic. Adults and children over the age of 6 will present the typical symptoms of a Hepatitis A infection, but 70% of these cases also present with jaundice, or yellowing of the skin and eyes. A case of Hepatitis A poisoning will abruptly produce symptoms in as soon as 15 days after infection, although it may take up to 50 days. The CDC reports that a Hepatitis A infection will produce symptoms after 28 days, on average.

Hepatitis A is a virus that targets the liver, and can cause symptoms including fever, vomiting, joint pain, nausea, clay-colored bowel movements, loss of appetite, dark urine, fatigue, abdominal pain, and jaundice. Although the symptoms will usually last for about 2 months, the CDC has said that there is between a 10 to 15% chance of relapsing within 6 months. There is no risk of the infection becoming chronic. Again, if you have already had a Hepatitis A infection, or you obtained the proper vaccination, there is no threat of infection from this outbreak. If you or a loved one begins to show the symptoms of a Hepatitis A infection, contact a medical professional.

 

Sources:

http://www.vdh.virginia.gov/news/health-alert-potential-hepatitis-a-exposure-at-local-restaurant/

http://www.vdh.virginia.gov/blog/2016/08/26/hepatitis-a-investigation/

http://search.cdc.gov/search?query=hepatitis+a&utf8=%E2%9C%93&affiliate=cdc-main

http://www.cdc.gov/hepatitis/hav/havfaq.htm#general