By: Heather Williams

Outbreak prevention measures are currently in place after patrons who consumed beverages at Monteverde at Old Stone, a restaurant and event space at 28 Bear Mountain Bridge Road in Cortlandt Manor in the state of New York.  An employee who was infected with Hepatitis A was serving beverages and may have infected patrons served between May 31st and June 10th.

The owners of the restaurant issued the following statement:

“In conjunction with the New York State and Westchester County Departments of Heath, Monteverde is taking all steps necessary to notify the public at large of this health advisory.  Monteverde would like the public to know that immediately upon being advised that an employee had been infected elsewhere with Hepatitis A, we have worked tirelessly to notify all those who had any contact with the person in question and will be cooperating with the Department of Health in all respects including an upcoming clinic.  Preliminary investigations have indicated that the infection did not originate at Monteverde, but Monteverde will be involved with all actions necessary to conclude this health concern.”

As soon as the county health department discovered where the employee worked, staff began a comprehensive investigation and had the full cooperation of the owner of the restaurant and consultation with the New York State Health Department.  “The key to prevention is a quick response, said Weschester County Executive Robert P. Astorino.

The Health Department has been contacting all individuals who dined at the restaurant during that period to provide appropriate preventative measures.  Treatment is a Hepatitis A vaccine or immune globulin.  Dr. Sherlita Amler, Westchester County’s Health Commissioner, is encouraging anyone who consumed beverages at the restaurant during that time period to contact the local health department and their doctor.  Pregnant women who may have been exposed should contact their prenatal care provider to discuss treatment options.  According to the health department, preventative treatment should be given within two weeks of exposure.

Public Reactions

 Monteverde, in conjunction with the County Health Department set up two clinics to offer patrons during the May 31st and June 10th time period a place to be screened and receive treatment.  Reactions have been mixed.

Some patrons are thankful and amazed that the restaurant has been tracking down all patrons who may have been exposed, while others are upset that they are having to go through the trouble of treating themselves because they were exposed to an infected employee.  Some are concerned because they have health conditions that will not allow them to receive the vaccine treatment.

Hepatitis A

 The word “hepatitis” literally means inflammation of the liver.  While we generally think about the viruses causing Hepatitis A, B, and C, hepatitis can also be caused by other things which inflame the liver.  Causes of non-viral hepatitis include heavy alcohol use, certain drugs, toxins, some disease, as well as other viral and bacterial infections.  While Hepatitis A, B, and C are each caused by different viruses, they present similar symptoms.  However, each viral version has different modes of transmission and can affect the liver in different ways.  Hepatitis A is a highly contagious disease of the liver resulting from infection with the Hepatitis A virus.  It is spread by ingestion by coming in contact with something contaminated by an infected person such as food, drinks, or objects contaminated by feces or stool.  Hepatitis A infection is at the lowest it has been in 40 years.  Since the Hepatitis A vaccine was introduced in 1995 and routinely administered to children and those traveling to at risk countries, as well as those more at risk of being infected, incidence of Hepatitis A infection has dramatically decreased in the United States.

How is Hepatitis A Spread?

Hepatitis A is generally spread by person to person contact, but can also be spread by eating or drinking food or water contaminated with the Hepatitis A virus.  This generally occurs in areas with poor sanitation or poor personal hygiene.  Food or drinks more likely to be contaminated include water, ice, fruits, vegetables, and shellfish.  In the United States, water chlorination kills Hepatitis A that might enter the water supply.

Most common forms Hepatitis A viral transmission is person to person contact.  This is generally transmitted by an infected person who does not wash his or her hands after going to the bathroom and then touches food or other objects.  It can be transmitted by a parent of caregiver who does not wash his or her hands after changing diapers or cleaning up stool of an infected person.  It can also be transmitted by sexual contact with an infected person.  This contact does not necessarily require anal-oral contact.

I Ate at a Restaurant Reporting Exposure to Hepatitis A.  What Should I Do?

 First, talk to your doctor or local health department official for guidance.  The health department will investigate whether the source was from an infected food source or an infected food handler.  The CDC explains that “most people do not get sick when someone at the restaurant has Hepatitis A.  However, if an infected food handler is infectious and has poor hygiene, the risk goes up for patrons of the restaurant.

If you identify that you may have been exposed to Hepatitis A within two weeks of exposure, Hepatitis A vaccination or immune globulin can prevent the onset of illness.  If you have ever had Hepatitis A your body has developed antibodies for the virus and you will not be infected again.  Infection with Hepatitis B or C does not provide immunity to Hepatitis A.

Symptoms of Hepatitis A

 Many people, children in particular, show no symptoms.  Unfortunately, infected people are contagious and can transmit the virus up to 2 weeks before experiencing any symptoms.  Onset of symptoms is a slow progression for most people.  If symptoms are present they may include the following: fever, nausea, vomiting, abdominal pain, joint pain, fatigue, loss of appetite, dark urine, clay-colored bowel movements, and jaundice (the yellowing of the skin or eyes).  These symptoms may begin between 2 and 6 weeks after exposure and generally persist less than 2 months, but some may remain ill for as long as 6 months.

Generally people recover completely without long-term effects.  However, those over 50 years old or have other liver diseases such as Hepatitis B or C may experience liver failure and death, as the liver is already compromised.

I Ate at a Restaurant Reporting Exposure to Hepatitis A.  What Should I Do?

 Whether you may have been exposed at Monteverde or another restaurant, first talk to your doctor or local health department official for guidance.  The health department will investigate whether the source was from an infected food source or an infected food handler.  The CDC explains that “most people do not get sick when someone at the restaurant has Hepatitis A.  However, if an infected food handler is infections and has poor hygiene, the risk goes up for patrons of the restaurant.

If you identify that you may have been exposed to Hepatitis A within two weeks of exposure, Hepatitis A vaccination or immune globulin can prevent the onset of illness.  If you have ever had Hepatitis A your body has developed antibodies for the virus and you will not be infected again.  Infection with Hepatitis B or C does not provide immunity to Hepatitis A.

 

 

Sources:

http://www.million-girls.beforeitsnews.com/food-and-farming/2017/06/hepatitis-a-link-at-monteverde-at-oldstone-2501859.html

http://abc7ny.com/health/hepatitis-a-warning-for-patrons-at-westchester-restaurant/2100241/

https://www.cdc.gov/hepatitis/hav/afaq.htm