Category Archives: Hepatitis A

To the importer who says there’s no proven link, I say, epidemiology still works: 18 confirmed sick with hep A from frozen Chinese berries

Posted on by
Reply

As the number of confirmed hepatitis A cases in Australia from frozen berries grown in China rose to 18 over the weekend, as political rhetoric about imports and local food reached staggering new heights, the company continued to insist there’s no firm link between a national hepatitis A outbreak and its recalled berries.

epidemiology.WATER PUMP3_Page_4The company says its imported Chinese berries were recalled on health department advice despite a lack of proof from accredited laboratories of a link to the hepatitis A virus (HAV).

“At this point, we have not been provided any remaining consumer product to test from the 13 confirmed HAV cases to clinically verify there is indeed a link with the Nanna’s Mixed Berries,” managing director and chief executive Stephen Chaur said in a statement on Friday.

Mr Chaur said the company had rigorous testing that went beyond the Australian standards requirement that five per cent of imported fruit containers be tested.

“Patties Foods’ documented test regime is among the highest, testing 20 per cent of all the containers when they arrive in Australia,” he said.

But Mr Chaur said sample testing for microbial and viral markers had been increased to 100 per cent of imported frozen berries from all countries.

The company has checked quality control testing documents back to June 2014 and says they’re satisfied no biological indicators outside Australian guidelines have been detected.

Great. Prove it and make the data public.

Hepatitis A vaccines work: Michigan, 2013

Posted on by
Reply

Hepatitis A virus (HAV) infections among persons with developmental disabilities living in institutions were common in the past, but with improvements in care and fewer persons institutionalized, the number of HAV infections has declined in these institutions. However, residents in institutions are still vulnerable if they have not been vaccinated.

hepatitis.AOn April 24, 2013, a resident of a group home (GH) for adults with disabilities in southeast Michigan (GH-A) was diagnosed with hepatitis A and died 2 days later of fulminant liver failure. Four weeks later, a second GH-A resident was diagnosed with hepatitis A. None of the GH-A residents or staff had been vaccinated against hepatitis A. Over the next 3 months, six more cases of hepatitis A were diagnosed in residents in four other Michigan GHs. Three local health departments were involved in case investigation and management, including administration of postexposure prophylaxis (PEP). Serum specimens from seven cases were found to have an identical strain of HAV genotype 1A.

This report describes the outbreak investigation, the challenges of timely delivery of PEP for hepatitis A, and the need for preexposure vaccination against hepatitis A for adults living or working in GHs for the disabled.

CDC MMWR 64(06);148-152

Susan R. Bohm, Keira Wickliffe Berger, Pamela B. Hackert, Richard Renas, Suzanne Brunette, Nicole Parker, Carolyn Padro, Anne Hocking, Mary Hedemark, Renai Edwards, Russell L. Bush, Yury Khudyakov, Noele P. Nelson, Eyasu H. Teshale

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a4.htm?s_cid=mm6406a4_x

Vaccines work: So says Kristen Bell (and Israel)

Posted on by
Reply

Data on long-term impact of universal national vaccination programmes against hepatitis A are lacking. We aimed at evaluating the impact on hepatitis A incidence of the Israeli toddlers-only universal routine two-dose vaccination programme against hepatitis A initiated in 1999.

kristen-bell1All hepatitis A episodes reported to the national surveillance system from 1993 to 2012 were analysed in relation to the vaccination programme and coverage. Mean vaccine coverage in Israel between 2003 and 2010 was 92% for the first dose, given at 18 months of age, and 88% for the second dose, given at 24 months.

The annual hepatitis A incidence declined from a mean of 50.4 per 100,000 in the period between 1993 and 1998 to a mean of <1.0, during the period from 2008 to 2012, representing a reduction of >98%. The decline was evident in all ages and ethnicity groups, including unvaccinated populations.

Of the 1,247 cases reported nationwide between 2002 and 2012, the vaccination status could be ascertained in 1,108 (89%). Among them, only 20 (2%) were reported be vaccinated with one dose and three (<1%) received two doses.

The sustained results of this long-term impact study suggest that a toddlers-only universal routine two-dose vaccination programme is highly effective and practical. These findings underscore the importance of sustainability in both the surveillance systems and vaccination programmes and will aid to determine vaccination policies.

The impact of a national routine immunisation programme initiated in 1999 on Hepatitis A incidence in Israel, 1993 to 2012

Euro Surveill. 2015;20(7)

Levine H, Kopel E, Anis E, Givon-Lavi N, Dagan R.

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=21040

http://www.today.com/parents/kristen-bell-get-vaccinated-whooping-cough-if-you-want-hold-2D80499716

And Penn and Teller (NSFV).

Lots of support for restaurant that had food handler with hepatitis A

Posted on by
1

n a truly Canadian move, more than 70 owners, management and staff from Sudbury bars and restaurants ate and drank at a Sudbury, Ontario (that’s in Canada) Casey’s in a show of solidarity. In early February over a thousand patrons might have been exposed to hepatitis A after a food handler was diagnosed with the virus. According to The Sudbury Star, even the local health unit, the folks who ran the hep A shot clinics, hosted a retirement party for over 40 folks at the restaurant.default-1

Last week, Peddler’s Pub invited fellow establishments to join them in a show of support for the Kingsway bar and grill, which suffered a publicity setback last month when an employee was diagnosed with hepatitis A and patrons were urged to get vaccines through the Sudbury and District Health Unit.

“It’s one of those unfortunate things that can happen to any restaurant,” said Peddler’s marketing manager Cliff Skelliter. “Casey’s is such an important part of our community. A lot of people have jobs there and the owners are amazing, just absolute sweethearts.”

Dave Temmerman, co-owner of Hard Rock, brought a contingent of 14 people affiliated with his Elm Street pub.

“In times like this it’s nice to know who your friends are and stick together,” said Temmerman.

The public should have no fear of dining at Casey’s, he said, as standards of hygiene at this restaurant are as strict as any he’s encountered.

“I’ve worked in a lot of places, and it’s one of the cleanest I’ve worked in,” he said. “What happened to them is just a bad deal. People in the industry know it can happen to anybody, and it’s not because their place is dirty.”

Casey’s owner Marty Wills said the endorsement of counterparts means a lot.

“It’s wonderful what all the other restaurants have done,” he said. “They’ve been getting together and showing a little love, a little support for us, because they understand we didn’t do anything wrong.”

The hepatitis A that was detected in a Casey’s employee “was never created here,” said Wills. “She just happened to work here.”

Having a clean restaurant (whatever that means) doesn’t really matter; in this situation, risk is influenced by the food handler’s handwashing behavior. US FDA risk factor studies have shown that handwashing compliance in food service isn’t great. Requiring your staff to have hep A vaccinations would avoid stuff like this.

Hepatitis A in Nanna’s berries; seen and heard

Posted on by
Reply

As companies and consumers check their freezers, past menus and, receipts, health officials anticipate that confirmed cases will continue to grow (The Age):

The number of cases of Hepatitis A linked to the consumption of frozen berries imported from China has climbed to at least 14.

Thirty-four government schools have advised the Victorian Education Department that some of their students have consumed berries that have been recalled because of the hepatitis A imported frozen berry outbreak.1424036630491

The number of schools affected suggests that potentially hundreds of students ate berries from one of four lines of frozen berries before they were recalled in recent days by Bairnsdale-based food company Patties Foods.

 

Another example of questioning the world of epidemiology; gotta be tough to be an epi (Business Insider Australia):

On its website, Patties Foods says “The link between our products and the reported illnesses has not yet been confirmed,” in response to its own question about meeting medical costs.

“This makes it too early to comment,” the company said.

The local-food-is-safer contingent is out – without data (Sunshine Coast Daily):

Long-time Chevallum strawberry farmer Rick Twist, co-owner of Twist Brothers, said he could not understand why people continued to risk purchasing overseas products to save a few dollars when the integrity of local produce was so much higher.

“Why the hell do people buy this stuff from those countries when their standards are so low and ours are so high?” Mr Twist said.

“Australian berries… our regulations are so tight and so strong, I think they’re the best in the world.”

And the outbreak has hit rugby (Yahoo News):

The Tigers confirmed on Tuesday that three senior players had approached club management on Monday with concerns that berries they ate may have been contaminated.

Captain Robbie Farah and veteran winger Pat Richards were later named in news reports as two players who underwent precautionary blood tests for the virus.

[Coach Jason] Taylor declined to name the trio of players but said they had shown no symptoms and the club had no confirmed cases of infection.

“It’s really simple. A couple of guys have eaten some of the berries that have been recalled, and that’s the end of the story,” Taylor said.

“We’re not overly concerned about it. We’re just being really cautious. It’s a smart move to make sure we are ticking all the boxes and all the guys are OK.

“We don’t feel that is going to come to that point (of infection) but we are doing due diligence on it.”

Some good amateur medical assessment there, Coach Taylor.

Charlotte restaurant server diagnosed with hepatitis A

Posted on by
Reply

When I was a PhD student I volunteered as a dishwasher in a restaurant as part of my food safety-related research. I saw lots of things, but the two things I remember most is that I was often asked to work with a server to do some salad plating; and I had to listen to a lot of Pink Floyd.

There was some Tom Petty, and The Clash, but a lot of Pink Floyd.

Servers, while not traditionally thought as food handlers, are often involved with scooping beverage ice, putting silverware together and sometimes, as I experienced, salad preparation.mondo_446339a

And when a server is confirmed ill with hepatitis A, even if they are superstars at handwashing, a whole lot of business hurt happens. Stuff like public health clinics and loss of confidence.

According to WCNC, a server at a Charlotte-area restaurant, Dogwood Southern Table and Bar, has the virus and may have exposed patrons in early February.

Health officials say the worker did not prepare food, but was responsible for polishing silverware and severing food. Monday afternoon, the Health Department offered a walk-in clinic for free vaccination.

One customer who received the vaccination, who did not want to be identified, said she was surprised by the news.

“I’m very concerned because I have small kids at home and so I worry about not just myself, but my family, and so it’s unfortunate.”

So far about 20 people have been vaccinated. 

‘I’m massively jaundice and my liver’s pretty crappy’; hepatitis A victim speaks

Posted on by
1

Hepatitis A is a pretty nasty foodborne virus, often leading to long term liver issues. According to the Daily Mail, one of the folks in a cluster of hep A illnesses linked Chinese-grown berries in Australia is speaking out.

Trudie Sims, from Ballarat in Victoria, had been using Nanna’s frozen berries in smoothies until Sunday evening, when she was alerted to the health warning which had been issued.

‘I’m really angry … (and) it’s absolutely terrified me’, Ms Sims told Daily Mail Australia.

So far four cases of hepatitis A have been confirmed in Queensland, three in Victoria, and two in New South Wales. Ms Sims’ case could take the national toll to ten.

‘Over the last two to three weeks I’ve been getting quite sick and I just thought it was a flu,’ Ms Sims revealed.

‘Last night I just couldn’t really swallow anymore and I was going to make a frozen drink like I have been for the last four to six weeks,’ she added added.

After her partner Trevor alerted her to the health warning which had been issued when he saw Ms Sims with a packet of Nanna’s berries – he rushed her to hospital.

Since her admission her eyelids have turned yellow and she is exhibiting signs of jaundice.

‘I’m massively jaundice and my liver’s pretty crappy and these are the first signs of hep A from the berries,’ Ms Sims revealed. 

Though still awaiting the definitive results of her blood tests, Ms Sims said her doctor was almost certain she had hepatitis A, news which left her in tears.

The Ballarat woman said she feels betrayed by the food company, and claims she was misled over the origin of the product which she thought were Australian made.

‘I’m really angry’, Ms Sims said before adding ‘It’s disgusting. We’re in Australia – we have our own resources.’ 

She now faces at least a week of unpaid leave from her casual job, is on heavy antibiotics and can’t even kiss her partner.

Ms Sims said she was beside herself when she found out, especially since she and partner Trevor visited his sick mother in hospital just last week. She hopes that she did not pass on any virus.

And the import blame game has started.

Victorian Farmers Federation president Peter Tuohey said not all imported food adhered to Australia’s strict guidelines which were some of the best health and safety standards in the world.

Mr Tuohey urged consumers to always buy Australian made products but conceded identifying those products could be quite challenging. 

‘I can only assume that this company is using Chinese berries because they are offering a lower market price,’ he told The Herald Sun. ‘Berries are certainly in season in Australia.’ 

He said that it was likely the berries were contaminated when they were first picked.

‘They may have been placed on the ground where rats and other vermin could have caused the problem,’ he said.

‘Unfortunately, Australian Customs don’t test every batch, they only check a certain percentage of shipments.’

The cost of an outbreak: hepatitis A edition

Posted on by
Reply

The folks who run food safety at big companies often talk about the challenges they face when it comes to asking for resources. It’s all about return on investment.

I don’t know much about ROI, an 18% drop in stock isn’t good. According to Reuters that’s what the firm who sells Nanna’s berry mixes are experiencing. falling-stocks

Shares in Australia’s Patties Foods Ltd fell as much as 18 percent on Monday after it recalled its frozen berry products following a hepatitis A outbreak that has been linked to poor hygiene and water supplies in a Chinese packaging plant.

Shares were down 12.4 percent at A$1.20 in early trade, after falling as low as A$1.14.

More cases expected in Australian frozen berry hepatitis A outbreak

Posted on by
4
Berries are a staple of my diet; I go through about 2 lbs a week of raspberries, blackberries and strawberries. When the fresh berries are too expensive (or don’t look good) I substitute with frozen ones – and often cook them before eating after the multiple noro and hep A outbreaks in the past few years.
According to ABC (the Australian one), another illness in New South Wales has been linked to Nanna’s frozen mixed berries, bringing the number of outbreak cases up to five.
 
A second case of hepatitis A linked to Nanna’s frozen mixed berries has been confirmed in New South Wales.6099244-3x2-340x227
 
It follows the identification of three cases in Victoria linked to the same product.
 
The NSW Health department has issued a warning urging consumers not to eat the product with best-before dates up to and including November 22, 2016.
 
The department said it was not sure how many others may be affected given the berries are widely distributed and the potential for people to develop the disease in the coming weeks.
 
Dr Vicky Sheppeard from NSW Health’s Communicable Diseases Branch said there were concerns because hepatitis-A was contagious.
 
“So far we’ve had two people that have confirmed hepatitis A, that in the weeks to months before they developed hepatitis A had consumed these berries and they’re coming from different parts of the state, so we’re concerned this might be a more widespread problem,” said Dr Sheppeard.
 
Dr Sheppeard said NSW Health were expecting more cases to arise.
 
“The incubation period for hepatitis A is between two and seven weeks, so at this stage it’s an early stage of the investigation and we’re still gathering information about how much of the product is in NSW homes but potentially we will be seeing more cases in the coming weeks,” said Dr Sheppeard.

69 sick: Water supply causes mass hepatitis A infection in Russia

Posted on by
Reply

Water supply companies in Russia’s republic of Dagestan are facing a criminal investigation after 69 people became infected with Hepatitis A from drinking water.

dangerous_face_waterAn online statement posted Thursday by Russia’s health watchdog Rospotrebnadzor said that cases were recorded in three different places in the North Caucasus republic: the towns of Derbent and Dagestanskiye Ogni and the village of Gedzhukh. Fifty-eight of those infected were children.

The victims all complained of feeling generally ill and noticing a yellow tint to the skin, the RGVK Dagestan television channel reported.

Laboratory testing indicated that the local water supply was to blame for the outbreak, according to the statement, noting that all the victims received their drinking water from the same water main.