By Eva Frederick

People who ate tuna served at several restaurants and supermarkets on the island of Oahu between April 27 and May 1 may have been exposed to the Hepatitis A virus, according to a recall notice from the FDA. The recall notice was issued on Wednesday.

The cubed, frozen fish was imported from Indonesia and distributed by Tropic Fish Hawaii LLC, a company on Oahu that sells seafood to restaurants, hotels, and other businesses on the island. It was used in food prepared at Times Supermarket and Shima’s locations in the towns of Aiea, Kailua, Kaneohe, Kunia, Liliha, Mililani, Waipahu, and Waimanalo.  Several other businesses, including GP Hawaiian Food Catering, the Crab Shack Kapolei, Aloha Sushi at 3131 N. Nimitz, and the ABC store at 205 Lewers St., also sold the tuna to the public according the the recall notice.

Some of the cubes of fish were used to make poke (pronounced POH-keh), a popular dish in Hawaii made of cubed raw fish and various other ingredients like onions, sesame seeds, spices and seasonings. Due to the raw nature of the dish, the fish would not be cooked at a high-enough temperature to kill any contaminating viruses.

The contamination was detected quickly. As soon as Tropic Fish Hawaii LLC officials saw the results of the safety tests on the fish, they took action to contact health authorities and issue a recall. According to the company, the tuna was imported from Indonesia before the safety test results were received, which is not normally how the business operates.

Peter Oshiro, chief of the DOH Food Safety Program, praised Tropic Fish Hawaii’s record-keeping and handling of the situation. Because of the company’s timely notification, the situation is currently under better control than it might have been otherwise.

“All of the product is being traced, collected and held by the distributor,”  Oshiro said in the recall notice. “Fortunately, in this case, Tropic Fish Hawaii kept excellent records and has been contacting all retailers and pulling the product quickly.”

In the notice, the FDA officials recommended that people who may have consumed the tuna get a Hepatitis A vaccine or a shot of immunoglobulin, which contains antibodies that destroy the Hepatitis A virus and prevent infection. Immunoglobulin is most effective if delivered within one week after contracting the virus, so people who think they may have ingested the contaminated tuna should get the vaccine as soon as possible even if they do not show any symptoms (the symptoms of Hepatitis A generally show up anywhere from two to seven weeks after infection).

The FDA also advised people who may have been infected to monitor for symptoms of the disease for up to 50 days after eating the tuna, and to wash their hands frequently with warm water and soap, particularly after using the bathroom and before preparing food. For people who develop symptoms of Hepatitis A, the FDA recommended that they remain at home and contact their healthcare provider.

This recall comes after a larger Hepatitis A problem on Oahu last summer, in which nearly 300 people were infected and 74 people were hospitalized after contracting the virus from contaminated scallops. There have been no reported cases of Hepatitis A related to the recalled tuna on Oahu, but because the incubation period for Hepatitis A is so long it is often difficult to track.

What is Hepatitis A?

Hepatitis A is a virus that causes inflammation of the liver. Symptoms typically begin two or more weeks after infection, and they include jaundice, fever, loss of appetite, nausea, and dark urine. Not all people who contract Hepatitis A show symptoms, but they can still spread the disease. Although most cases last for less than two months, approximately 10-15 percent of people have relapsing cases that last from 6-9 months. Infected people may be too ill to work, according to the Center for Disease Control. A small fraction of people who contract Hepatitis A can experience more severe complications, which can sometimes lead to liver failure and death.

There is no quick-fix or special treatment for Hepatitis A–people who have contracted the disease have to wait it out for a few weeks to a few months. Some require hospitalization. According to the CDC, doctors usually recommend that Hepatitis A patients rest, drink plenty of fluids and get adequate nutrition.

In terms of person-to-person transmission, Hepatitis A is not hugely contagious. It is primarily spread through fecal-oral transmission, which means that someone would have to ingest something contaminated with the feces of an infected person to contract the disease. This can happen in a number of ways, so infected people should be careful to wash their hands after using the bathroom or changing a diaper and before cooking. In rare cases Hepatitis A can be spread through sexual contact. Fortunately, the virus is not generally transmitted through routine every-day contact like shaking hands or playing on a playground. It can also be spread when food workers touch contaminated food and then work with other food products.

Because the virus is often spread through contaminated food or water, people in developing countries have a far higher risk of contracting the disease than people in first world countries like the U.S. or much of Europe. The United States began recommending residents to get vaccinated for the disease in 1996. Before 1996, there were 30,000 to 50,000 cases each year in the U.S. In the years since then, that number has dropped to around 2,500 in 2014, according to the CDC. Because the disease is still prevalent in many countries, doctors often recommend travelers getting the vaccine before they depart.

Hepatitis A is a serious disease. If you or someone you know may be at risk of contracting Hepatitis A, contact your healthcare provider immediately. Immediate medical attention is recommended if you are showing the signs and symptoms of Hepatitis A. To learn more about vaccines, symptoms and treatment of Hepatitis A, the CDC has a helpful FAQ page on the disease. For more information on the FDA’s recall of tuna in Hawaii, read the recall notice here.