Hepatitis A Continues to Spread in the United States

Updated on 10/24/2016 at 1:019 PM EST

Hepatitis A has been making headlines lately as at least nine states have reported new cases of infections. Hepatitis A is a highly contagious disease that can be transmitted by eating any food or water that has been contaminated with the hepatitis A virus, or through contact with an infected individual. Due to the fact that it can spread quickly, hepatitis A infections can result in outbreaks that can cost a substantial amount of money to quell.

Last month, the Virginia Department of Health (VDH) issued a warning that there was an increased risk of hepatitis A in Virginia. Further investigation indicated that contaminated strawberries found in smoothies from Tropical Smoothie Café restaurants were the likely source for the outbreak. The contaminated strawberries had been imported from Egypt, and since August 8th, the strawberries have been removed from Tropical Smoothie Café locations. As a further precaution, the smoothie restaurant also switched suppliers for all locations throughout the nation, according to a recent Centers for Disease Control and Prevention (CDC) press release.

In addition to being highly contagious, hepatitis A has a long incubation period, and so an infected individual might not exhibit any symptoms until up to 50 days after they have become infected. Indeed, the CDC are continuing to identify a number of cases of individuals who had ingested the contaminated strawberries and have only recently started to exhibit evidence of infection.

So far, eight states have reported hepatitis A cases that are thought to be linked with the imported strawberries: Arkansas (1), Maryland (12), New York (3), North Carolina (1), Oregon (1), Virginia (107), West Virginia (7), Wisconsin (5), and now, California (1), according to the CDC. There are currently 134 reported cases of infection. 52 of these individuals have had to be hospitalized. Almost all of the infected individuals residing in North Carolina, Maryland, West Virginia, and Virginia report to have consumed strawberry smoothies from Tropical Smoothie Café locations.

In addition to the hepatitis A outbreak linked with strawberries, there has been another hepatitis A outbreak linked with raw scallops that had been provided by Sea Port Products Corp. in Hawaii. The outbreak was found when the Hawaii Department of Health (DOH) teamed up with the Food and Drug Administration (FDA) and the CDC to conduct a traceback investigation and found the link when examining scallop samples that had been imported by Sea Port Products Corp. and used within Genki Sushi restaurants.

Since then, the number of cases of hepatitis A linked with raw scallops continues to rise as more locations are linked with the contaminated food products. Among the establishments are: Papa Johns, Oahu, on Waipahu Street, and New Lin Fong bakery in Chinatown on Oahu. However, as of yesterday an additional case of the infection was confirmed in an Ohana food service worker in the Sam’s Club located in Pearl City, according to a recent press release. The Hawaii DOH has reported 271 confirmed cases of hepatitis A in Hawaii, so far, and they’re expecting more every day.

State Epidemiologist, Dr. Sarah Park, MD, FAAP, commented, “We expect to continue seeing new cases of hepatitis A infection through at least early October because of the long incubation period of this illness, even though the source of the outbreak has been identified as contaminated scallops. While this case involves a food handler working with raw seafood, the food handler is another victim, and none of the products sold by Ohana Seafood at Sam’s Club have been identified as a source of the ongoing outbreak.”

The Hawaii DOH reminds the public that they will continue to provide further information about the outbreak every Wednesday. Their website includes a list of food establishments that have reported contaminated food products, a list of all the different pharmacies in the state that provide vaccination opportunities, as well as prevention guidance.

The best way to prevent hepatitis A infection is vaccination, according to the CDC; they attribute the overall decrease in the number of hepatitis A cases throughout the last decade to vaccination efforts. In addition to recommending the vaccine be administered as a part of childhood vaccination series, the CDC also stress the importance of proper hand hygiene; washing your hands thoroughly with soap and water throughout the day, especially when dealing with food or after using the bathroom.

Anyone who has consumed any of the contaminated products mentioned here, or are exhibiting symptoms (such as pale stool, stomach pain, or yellowing of the skin or eyes) should seek immediate medical attention.