If you ate at this Tampa burger joint recently, officials recommend hepatitis A vaccination

Tampa, or more accurately Sarasota, is equidistant from the equator as is Brisbane.

I have a strong, childhood-based link to that area of Florida and probably why I’ve settled into Brisbane.

Or it’s the familiarity in targeted advertising for funeral homes and life insurance.

A food service worker employed at Hamburger Mary’s Bar and Grille in Ybor City has tested positive for hepatitis A, according to the Florida Department of Health in Hillsborough County.

The individual worked at the restaurant between Oct. 4 and Oct. 20, an investigation found.

Anyone who frequented the restaurant within the time period and has not previously received a hepatitis A vaccination is advised to do so as soon as possible. Those who have previously had a hepatitis A vaccination do not need to take any additional action.

A 24-hour hotline has also been set up for people who have questions about hepatitis A. It can be reached at 813-307-8004.

Doctor’s offices, pharmacies and state and local health departments offer hepatitis A vaccinations. Find out more at vaccines.gov.

Vaccines work: US advisory group urges hepatitis A shots for homeless

And I would urge Hepatitis A shots for all food service employees.

For the first time, a U.S. advisory committee is recommending a routine vaccination for homeless people, voting Wednesday to urge hepatitis A shots to prevent future outbreaks of the contagious liver disease.

Carla Johnson of ABC News reports the Advisory Committee on Immunization Practices made the recommendation at a meeting in Atlanta. The Centers for Disease Control and Prevention is expected to adopt it and send guidance to health care providers.

Homeless encampments can contribute to disease through unsanitary conditions. Hepatitis A spreads person to person through contaminated food or dirty needles used for injection drugs. The virus also can spread from sexual contact with an infected person.

The recommendation would make it easier for shelters, emergency rooms and clinics that serve the homeless to offer hepatitis A shots along with other services.

Hepatitis A vaccinations already are recommended for children at age 1 and for others in danger of infection, such as drug users, some international travelers and men who have sex with men.

The committee of health experts voted unanimously to add homeless people to those groups. The panel is charged with developing recommendations for the CDC on the use of vaccines in the United States.

Health experts have seen an increase in hepatitis A outbreaks and suspected exposures, caused in part by homelessness and drug use.

Twelve states have reported more than 7,500 hepatitis A infections from January 2017 to October 2018, according to the CDC. There were more than 4,300 hospitalizations and about 74 deaths.

Homeless people have made up a large percentage of the cases in San Diego and Utah. Michigan, Kentucky, West Virginia and Tennessee have also reported cases among homeless people.

With even low rates of routine vaccination, the spread of hepatitis A can be slowed, Dr. Noele Nelson of the CDC told the committee before the vote. The recommendation is for a two-dose series of shots, but even one dose can provide immunity for 11 years, Nelson said.

At $28 per dose, a price available through the public health system, the cost of routine vaccination could be in the millions of dollars, Nelson said, but fighting a prolonged outbreak can be even more expensive and disruptive to the health care system.

Strawberry fields forever: At least 20 sickened with hepatitis A linked to frozen berries from Poland

Hepatitis A virus is an important cause of food-borne diseases and has been associated with several European outbreaks linked to berries [14]. Here, we describe an ongoing outbreak of hepatitis A virus (HAV) in Sweden and Austria and the confirmation of frozen strawberries imported from Poland as the source of infection. The aims are to highlight the importance of sequencing in outbreak investigations and, due to the long shelf-life of the food vehicle, to increase awareness and warnings towards HAV infections related to frozen strawberries in Europe.

According to a report by the scientific journal Eurosurveillance, 20 cases of hepatitis A were reported in six districts of Sweden between June and September 2018, of which 17 were confirmed and three were likely. “In combined epidemiological and microbiological studies, imported frozen strawberries produced in Poland were identified as the source of the outbreak,” the journal said. Also in Austria hepatitis A diseases have been associated with strawberries from the same manufacturer.
Swedish and Austrian researchers have identified strawberries as a source of infection for many hepatitis A diseases in their countries. “Examinations and interviews with kitchen staff showed that the strawberries had never been sufficiently heated before serving. Strawberries were the only food that was common to all cases, “says the Swedish experts.

The best protection against hepatitis A is vaccination, which is available for children 12 months and older.

Hepatitis A outbreak linked to imported frozen strawberries by sequencing, Sweden and Austria, June to September 2018

Eurosurveillance 2018;23(41)

Theresa Enkirch1,2Ronnie Eriksson3Sofia Persson3Daniela Schmid4Stephan W. Aberle5,Emma Löf1,6Bengt Wittesjö7Birgitta Holmgren8Charlotte Johnzon9Eva X. Gustafsson8,Lena M. Svensson10Lisa Labbé Sandelin11Lukas Richter4Mats Lindblad3Mia Brytting1,Sabine Maritschnik4Tatjana Tallo1Therese Malm12Lena Sundqvist1Josefine Lundberg Ederth1

 https://doi.org/10.2807/1560-7917.ES.2018.23.41.1800528

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.41.1800528

Frozen berries should be boiled

This is why we boil berries at home.

Hepatitis A virus is an important cause of food-borne diseases and has been associated with several European outbreaks linked to berries [14]. Here, we describe an ongoing outbreak of hepatitis A virus (HAV) in Sweden and Austria and the confirmation of frozen strawberries imported from Poland as the source of infection. The aims are to highlight the importance of sequencing in outbreak investigations and, due to the long shelf-life of the food vehicle, to increase awareness and warnings towards HAV infections related to frozen strawberries in Europe.

Hepatitis A outbreak linked to imported frozen strawberries by sequencing, Sweden and Austria, June to September 2018

Theresa Enkirch, Ronnie Eriksson, Sofia Persson, Daniela Schmid, Stephan W. Aberle, et al

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.41.1800528#html_fulltext</a

Food Safety Talk 166: Surprising lack of cannibalism questions

Don and Ben traveled to SUNY Geneseo for a live version of the podcast sponsored by the Center for Integrative Learning, and hosted by the amazing Beth McCoy. The episode title comes from an unrecorded after dark which may or may not have taken place in a bar in Geneseo.

Episode 166 is available on iTunes and here.

Show notes so you can follow along at home.

Vaccines work: Beware the Hep A in Denmark from Morocco

On 2 May 2018, Denmark reported a cluster of hepatitis A virus (HAV) infections with the subgenotype IA strain DK2018_231, through the European Centre for Disease Prevention and Control (ECDC)’s Epidemic Intelligence Information System (EPIS) for food- and waterborne diseases and zoonoses (FWD).

One of the three confirmed cases had travelled to Morocco. In response, five additional European Union (EU) countries (France, Germany, the Netherlands, Spain and the United Kingdom (UK)) reported cases (n = 20) infected with the same strain between 21 January and 10 April 2018.

Concurrently, Germany reported to EPIS that it observed more cases of hepatitis A with travel history to Morocco than expected, compared with the same period in the previous 5 years. Molecular analysis of the HAV VP1/P2A region revealed an unrelated cluster of the HAV subgenotype IB strain V18–16428. Cases infected with this unrelated strain were also reported from France, the Netherlands, Sweden and UK.

The appearance of clusters with a link to Morocco triggered further epidemiological investigations.

Two concurrent outbreaks of hepatitis A highlight the risk of infection for non-immune travelers to Morocco, January to June 2018

5.july.18

Eurosurveillance

Martyna Gassowski, Kai Michaelis, Mirko Faber, Julie Figoni…

https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2018.23.27.1800329

1 dead, 24 sick check your freezers: Hepatitis A death linked to frozen pomegranate recall in Australia (grown in Egypt)

Now for something more serious from Australia.

SA Health chief medical officer and chief public health officer Professor Paddy Phillips revealed a 64-year-old woman died last Wednesday after “some time” in hospital.

“This is a rare and tragic case and I offer my sincere condolences to the woman’s family,” Professor Phillips said.

“The majority of people infected with hepatitis A recover fully and the woman’s death is the only death linked to this recalled product nationally to date.

“The incubation period for hepatitis A is generally 15-50 days, so we don’t anticipate further cases because the product was recalled two months ago.

“While we expect most people would have disposed of the recalled product, we urge everyone to double-check freezers and remove any affected products.

“Fresh pomegranate and frozen Australian-grown pomegranate products are not affected.”

Her death had been referred to the Coroner.

The Creative Gourmet 180g frozen pomegranate arils, which are sold at Coles supermarkets, were first recalled in April after a hepatitis A outbreak in New South Wales.

Then in May, SA Health again reminded people to throw away the product, made by Entyce Food Ingredients, after 11 linked hepatitis cases.

Professor Phillips said some 2,000 packets of the fruit — grown in Egypt — were sold.

Of those, 226 packets were returned, but he said they believed many more were thrown away as instructed by health authorities.

He said it was “very rare” to die from hepatitis A.

“Most people usually recover without any consequences but occasionally this does happen,” he said.

He would not say if the woman suffered other medical conditions.

SA Health was told about the woman’s death yesterday, Professor Phillips said.

“We have come out as soon as we found out about it.”

Michigan’s hepatitis A problem is a public health cycle

Next month I’ll be in Michigan talking food safety with Don at a live podcast recording as part of the Global Food Law Current Issues Conference.

Added to the list for our chat is a local issue, a massive hepatitis A outbreak. Tragically, according to USA Today, the outbreak has been linked to 27 deaths and hundreds of cases.

Wrapped up in this outbreak is the intersection of intravenous drug use; individuals in the homeless population; and, folks working in food service. Public health is complicated.

Most of those who have died in Michigan in this outbreak are 50 or older, Fielder said. And they died of liver failure, septic shock or other organ failure.

“Generally, it’s been people who are more sick or people who have less access to health care,” Fielder said. “You know, we’ve also seen a homeless component to this. We’re seeing this driven by a substance use disorder risk group.”

People who use illegal drugs account for about half of outbreak-related cases..

“It’s a very hard group to reach, and it’s a very hard group to get public health messaging to. There’s a lot of trust issues with government entities in general. So there’s a lot of outreach going out from local public health to … people they do trust in the community.”

As of Wednesday before Memorial Day, the hardest hit areas are Macomb County, north of Detroit, with 220 cases; Detroit itself with 170; elsewhere in Wayne County, where Detroit is located, with 144; and Oakland County, to the west of Macomb County where Pontiac is located, with 114 cases, according to the Michigan Department of Health & Human Services.

Part of the problem: As many as 35 restaurant workers in the Detroit area were found to have the virus and may have spread it unknowingly to diners. The virus is contagious weeks before a person begins to exhibit symptoms, which makes it extremely challenging for public health officials to manage.

11 now sick in Australia linked to Creative Gourmet frozen pomegranate

Two South Australians have been hospitalised with Hepatitis A, believed to have been caused by them eating Creative Gourmet frozen pomegranate.

The product was recalled from Coles last month but SA Health is reminding South Australians to make sure they do not have the product in their freezers.

SA Health food and controlled drugs director Fay Jenkins said nationally there have been 11 cases linked to the outbreak, with two in South Australia.

“There’s a lady in her 60s and she is quite unwell and she is in hospital. There is a younger gentleman [aged 33] … and he’s actually been discharged from hospital,” Dr Jenkins said.

People are sick: Frozen strawberries grown in Egypt recalled because of hep A in Canada

For at least the third time in the last six years, people have gotten sick with hepatitis A after consuming strawberries – fresh or frozen — grown in Egypt.

A multistate outbreak of hepatitis A virus (HAV) among European travellers returning from Egypt occurred between November 2012 and April 2013.

A total of 14 European Union (EU)-European Free Trade Association (EFTA) countries reported 107 cases. Twenty-one cases from six countries were affected by strains of sub-genotype IB harbouring identical RNA sequences, suggesting a common source outbreak.

In Sept. 2016, at least 89 were sickened in the U.S. with hepatitis A at Tropical Smoothie Cafés in Maryland, North Carolina, Virginia, and West Virginia, linked to consumption of frozen strawberries from Egypt.

Now, the Canadian Food Inspection Agency says Groupe Adonis Inc. is recalling Montana brand frozen strawberries from the marketplace due to possible Hepatitis A contamination. Consumers should not consume the recalled product described below.

The ministère de l’Agriculture, des Pêcheries et de l’Alimentation du Québec (MAPAQ) transmitted an alert to the news media concerning the affected product. Please click on the following link for details: https://www.mapaq.gouv.qc.ca/fr/Consommation/rappelsaliments/2018/04/Pages/3682.aspx (French only).

The following product has been sold exclusively from Adonis markets in Quebec and Ontario.

Recalled products

Brand Name Common Name Size Code(s) on Product UPC
Montana Strawberry
(frozen)
1 kg All codes purchased on or before April 14, 2018 6222000401487

If you think you became sick from consuming a recalled product, call your doctor.

Check to see if you have recalled products in your home. Recalled products should be thrown out or returned to the store where they were purchased.

This recall was triggered by findings during an investigation into a foodborne illness outbreak.

CFIA won’t say how many are sick, that’s up to the Public Health Agency of Canada.

And vaccines work.