Hepatitis A Reported in Food Service Worker from Eastport, Maine

Posted in Hep A,Hepatitis A,Our Blog,Outbreaks & Recalls on May 27, 2021

The Maine Center for Disease Control has discovered a case of Hepatitis A (acute hepatitis) in a food service worker who was employed in a deli inside an IGA grocery store. The store is located in Eastport, Maine which has a relatively small population of 1,326 residents as of 2019. The employee was working while infectious on the following dates: May 3-6, May 8, May 10-13, May 15, and May 18-20. Deli food items purchased on May 3-22 should be discarded or cooked thoroughly.

Maine CDC recommends that anyone who ate food prepared in the R&M IGA deli from May 13-22, 2021, receive hepatitis A vaccine within 14 days of their potential exposure. There is a 14-day window during which prophylaxis is effective after exposure.

What is Hepatitis A?

The Mayo Clinic gives a great description of what Hepatitis A is:

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver’s ability to function.

You’re most likely to get hepatitis A from contaminated food or water or from close contact with a person or object that’s infected. Mild cases of hepatitis A don’t require treatment. Most people who are infected recover completely with no permanent liver damage.

The Symptoms

Hepatitis A signs and symptoms typically don’t appear until you’ve had the virus for a few weeks. But not everyone with hepatitis A develops them. If you do, hepatitis signs and symptoms can include:

• Fatigue
• Sudden nausea and vomiting
• Abdominal pain or discomfort, especially on the upper right side beneath your lower ribs (by your liver)
• Clay-colored bowel movements
• Loss of appetite
• Low-grade fever
• Dark urine
• Joint pain
• Yellowing of the skin and the whites of your eyes (jaundice)
• Intense itching

These symptoms may be relatively mild and go away in a few weeks. Sometimes, however, hepatitis A infection results in a severe illness that lasts several months.

When to see a doctor

Make an appointment with your doctor if you have signs or symptoms of hepatitis A.

Getting a hepatitis A vaccine or an injection of immunoglobulin (an antibody) within two weeks of exposure to hepatitis A may protect you from infection. Ask your doctor or your local health department about receiving the hepatitis A vaccine if:

• You’ve traveled out of the country recently, particularly to Mexico or South or Central America, or to areas with poor sanitation
• A restaurant where you recently ate reports a hepatitis A outbreak
• Someone close to you, such as a roommate or caregiver, is diagnosed with hepatitis A
• You recently had sexual contact with someone who has hepatitis A

The CDC delves deeper into Hepatitis A

State and local health departments typically lead the investigations of local outbreaks of hepatitis A.  When requested by the health department, CDC can support health departments in these investigations by:

• Communicating with public health officials from states with reported cases and providing technical assistance;
• Gathering data reported by states on confirmed cases and evaluating and monitoring these data from a national perspective;
• Providing support on vaccine supply and distribution and vaccine response strategy development;
• Testing clinical specimens from suspected hepatitis A cases when requested by states;
• Providing technical assistance and answering questions related to molecular and serologic laboratory testing;
• Providing rapid assistance on the ground during outbreak investigations, often through a formal request by the state health department;
• Alerting clinicians, health care facilities, and public health officials around the country about current outbreaks and providing vaccine policy and clinical guidance for health care providers; and
• Providing information to public and health care providers through a variety of media.

Globally it is estimated that there are 1.4 million cases of hepatitis a per year. Unlike hepatitis B and C, hepatitis A infection does not cause chronic liver disease and is rarely fatal, but can cause debilitating symptoms and lead to acute liver failure, which is associated with high mortality. According to the World Health Organization (WHO) Several hepatitis vaccines are available internationally. Both inactivated and live attenuated hepatitis A vaccines are highly immunogenic and immunization will generate long-lasting, possibly life-long, protection against hepatitis A in children as well as in adults.

Vaccination against hepatitis A should be part of a comprehensive plan for the prevention and control of viral hepatitis, including measures to improve hygiene and sanitation and measures for outbreak control.

WHO recommends that vaccination against hepatitis A virus be integrated into the national immunization schedule for children aged 1 year or older, if indicated on the basis of local factors, including incidence of acute hepatitis A, level of endemicity, and consideration of cost-effectiveness.

The use of hepatitis A vaccine, rather than passive prophylaxis with immune globulin, is recommended for pre-exposure prophylaxis for individuals considered at increased risk, such as travellers to areas of higher hepatitis A endemicity, men who have sex with men, and people with chronic liver diseases. The vaccine can also be given as post-exposure prophylaxis to close contacts of acute cases of hepatitis A.

If you believe you have been infected by hepatitis a and need to discuss your options please contact Make Food Safe today. Consultations are free of charge.