Case zero still unknown and get vaccinated Hawaii Hepatitis A outbreak hits 135

Hawaii News Now reports the outbreak of Hepatitis A in the islands has now sickened 135 people, the state Health Department said Wednesday.

hep.aAll cases have been in adults, and 39 have required hospitalization.

The total number of cases statewide is up by 42 people since last week. The onset of illness ranges from June 12 to July 24.

This is by far the largest outbreak of Hepatitis A in the islands in decades. State health officials said the outbreak appears to be focused on Oahu, but its source remains unclear. Seven of those who have been sickened live on the Neighbor Islands; one visitor has returned to the mainland.

Still, patrons who ate at the identified establishments during the dates of service below are being asked to seek medical advice.

Business                                 Island Location                                 Dates of service

Baskin-Robbins                    Oahu  Waikele Center                    June 17-19, 21-22, 25, 27, 30, and July 1 and 3

Chili’s Oahu                          Kapolei                                              July 10, 12, 14-15, 17-18, 20-27

Costco Bakery                      Oahu  Hawaii Kai                            June 16-20

Hawaiian Airlines                                                                            July 1-26 (see flight list)

Sushi Shiono Big Island       Waikoloa Beach Resort                   July 5-8, 11-15, and 18-21

Taco Bell                                Oahu  Waipio                                   June 16-17, 20-21, 24-25, 28-30, and July 1-4, 6-7, and 11

Vaccinate: Hawaii Baskin-Robbins workers harassed, business crippled over Hepatitis A

Marisa Yamane of KHON2 reports the Baskin-Robbins at Waikele Center used to be the busiest in the state.

Now, it’s the emptiest.

baskin.robbins“That’s why we only have one person working now, because it’s really that slow,” Baskin-Robbins employee Erika Espiritu said.

On July 12, the Hawaii State Department of Health (DOH) announced that anyone who ate at Baskin-Robbins at Waikele Center between June 17 and July 3, 2016 (actual dates: June 17, 18, 19, 21, 22, 25, 27, 30, and July 1 and 3), may have been exposed to hepatitis A.

That’s because one of the workers there caught the virus.

Since then, business has dropped 75 percent.

“The toughest part is having to take in all the harassment because I worked the — I might tear up — I worked the next morning and people would call and say mean stuff, and you just have to take it in, because you can’t control what people think,” Espiritu said.

She said people have told them they want to sue the store, or that they want the store to pay for their family to get vaccinated.

In fact, state epidemiologist Dr. Sarah Park said the store is “not at fault. They should not be looked down upon. This could happen to any food establishment out there.”

“We don’t deserve to be harassed or slandered because it’s not fair. We didn’t ask for our employee to have the infection, you know,” Espiritu said.

With 52 sick vaccination is simple handwashing not so much: Hawaiian ice cream store worker confirmed with Hepatitis A, but source unknown

Gregg K. Kakesako of the Star Advertiser writes that patrons of a Baskin-Robbins ice cream store in Waikele Center during the last two months may have been exposed to the hepatitis A virus after one of the store’s employees was confirmed to have the disease, the state Health Department said today.

Baskin-RobbinsPeople who haven’t had the hepaptitis A vaccine or immune globulin and who consumed any food or drinks from the Waikele store on June 17, 18, 19, 21, 22, 25, 27, 30, and July 1 and 3 should contact their healthcare providers about getting vaccinated, which may provide some protection against the disease if administered within the first two weeks after exposure, the Health Department said in a news release.

There have been 52 cases of hepatitis A reported to and now confirmed by health officials.

All cases have been in adults on Oahu, 16 have required hospitalization.

“The source of this outbreak has still not been determined. In the meantime, we encourage all persons consider and talk to their healthcare provider about getting vaccinated,” said State Epidemiologist Dr. Sarah Park. “This case demonstrates the potential to spread hepatitis A virus to many others who remain susceptible. In an effort to stem the spread of disease, individuals, including food service employees, exhibiting symptoms of hepatitis A infection should stay home and contact their healthcare provider.”

The head of the Hawaii Restaurant Association, Gregg Fraser, said “It’s as simple as frequent hand washing with warm water. Not only wash it in the bathroom, but when you enter the kitchen. There (are) typically 2 or 3 points of hand washing. There is a hand-washing sink in the kitchen as well.”

“If I was a restaurant manager right now, I’d make sure that all of my employees had the vaccine. I’d even pay for it,” he said.

The vaccine part makes sense. The handwashing advice with warm water is wrong.

And how happy are restaurant owners going to be if their employees actually followed all government sanctioned advice, and didn’t work when they were sick, washed their hands everytime they were supposed to, like after scratching their nose, or wore cloves and then scratched their ass.

It’s not simple.

 

They shoot horses, don’t they? 180 food handlers at Malaysian bazaar yet to take anti-Typhoid jabs

The Terengganu Health Department found 180 food handlers in the Kuala Berang Ramadan bazaar who have not taken the compulsory anti-typhoid injections and did not go for food handling courses.

they.shoot.horsesIts director, Dr Mohammad Omar said checks on 130 premises on Saturday also found that 30 premises were maintained only moderately in terms of hygiene.

“Food handlers who do not take these jabs and who do not attend the course to handle food correctly will also not know how to maintain cleanliness or how to handle the raw food,” he told reporters after the launch of the Kemaman District level Food Hygiene and Safety Campaign.

Mohammad said inspections by the Food Safety and Quality Unit of the Hulu Terengganu District Health Centre also found that in terms of hygiene, 30 premises scored 50% to 75%, which is moderate, while 100 premises were in a good condition scoring 75% and above.

“We also took a sample of 16 high risk food, including ‘kuih’ that contained santan and chicken, to be analysed in the laboratory.

“So far we have not found any spoiled food as alleged by people on the social media but we will continue with follow-up inspections,” he said.

 

Good to publish negative results: A Salmonella vaccine in feedlot cattle doesn’t work

The efficacy of a Salmonella vaccine for reducing fecal shedding of Salmonella during the finishing period and lymph node (LN) carriage at harvest was investigated in commercial feedlot cattle.

Cattle-Heat-Load-ForecastingThe study was designed as a pen-level randomized complete block with two treatment groups, a Salmonella Newport siderophore receptor and porin proteins-based vaccine (VAC) and a nonvaccinated control (CON).

Cattle were randomly allocated into 24 pens within 12 blocks based on the time of allocation. Twenty to 25 fecal pats were collected from each of the study pen floors once a month from June to August 2013. During harvest, a minimum of 25 sub-iliac LN were collected from carcasses within each study pen. Fecal and pulverized LN samples were cultured for Salmonella quantification and detection. Mixed models were used to analyze the effect of vaccination on fecal shedding and LN carriage of Salmonella. Montevideo and Anatum were the predominant Salmonella serotypes among fecal samples and LNs; no Newport isolates were recovered.

Vaccination was not significantly associated (p = 0.57) with the prevalence of Salmonella in feces over time; the mean within-pen prevalence was 62.3% and 66.0% among VAC and CON, respectively. Sampling month was significantly associated (p < 0.01) with fecal prevalence; mean prevalence was 71.4% for June, 48.6% for July, and 70.8% for August. Across all pens, the cumulative prevalence of Salmonella in LN was 86.4%.

Vaccination resulted in no significant reduction in LN prevalence (p = 0.52); mean prevalence was 85.7% for VAC and 87.4% for CON groups. Although vaccinated cattle had numerically fewer Salmonella LN and fecal positives, there were no statistically significant vaccine effects.

Potential reasons for the lack of vaccine efficacy could include an overwhelming Salmonella exposure, a lack of cross-protection against non-Newport serotypes, and insufficient duration of immunity relative to harvest.

Efficacy of a Salmonella siderophore receptor protein vaccine on fecal shedding and lymph node carriage of Salmonella in commercial feedlot cattle

Foodborne Pathogens and Disease. June 2016, ahead of print. doi:10.1089/fpd.2016.2129

Cernicchiaro Natalia, Ives Samuel E., Edrington Thomas S., Nagaraja Tiruvoor G., and Renter David G.

http://online.liebertpub.com/doi/abs/10.1089/fpd.2016.2129

 

Vaccines work: Viral gastro reduced in Israel

Both rotavirus vaccines RotaTeq and Rotarix were efficacious against severe rotavirus gastroenteritis in clinical trials; yet real-world data on the effect of rotavirus vaccines on mild to moderate disease are limited.

rotavirus.vaccineWe used a large computerised database of Maccabi Health Services Health Maintenance Organisation (HMO), the second largest HMO in Israel covering 25% of the Israeli population, to compare the incidence of acute gastroenteritis (AGE) clinic visits in community settings (n = 302,445) before (2005–10) and after (2011–13) the introduction of universal rotavirus immunisation in Israel.

We retrieved laboratory results of rotavirus antigen tests (n = 18,133) and using a weighted analysis, we estimated the impact of rotavirus immunisation on the disease burden of rotavirus AGE clinic visits. Following the introduction of universal rotavirus immunisation, the typical winter peaks of rotavirus AGE were substantially lower and significant reductions of 14.8% (95% confidence interval (CI): 13.5–16.1) in all-cause AGE clinic visits and of 59.7% (95% CI: 59.8–62.6) in rotavirus AGE clinic visits were observed. The decrease was observed in all age groups, but it was greater in children aged 0 to 23 months than those aged 24 to 59 months. Continued rotavirus laboratory surveillance is warranted to monitor the sustainability of these changes.

Change in incidence of clinic visits for all-cause and rotavirus gastroenteritis in young children following the introduction of universal rotavirus vaccination in Israel

Eurosurveillance, Volume 20, Issue 42, 22 October 2015

K Muhsen, G Chodick, S Goren, E Anis, T Ziv-Baran, V Shalev,  D Cohen

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=21281

Vaccines work: More than 3700 people vaccinated after possible Hardee’s Hepatitis A exposure in SC

The South Carolina Department of Health and Environmental Control (DHEC) says it has provided 3,706 vaccinations through its hepatitis A vaccine clinics in Spartanburg and Greenville.

hardee'sThey say vaccinations are being offered to individuals who might have been exposed to hepatitis A at two Hardee’s restaurants located in Spartanburg County.

The restaurants are located at:

12209 Greenville Highway in Lyman

1397 E. Main St. in Duncan.

DHEC’s Spartanburg and Greenville county health departments will continue to provide post-exposure treatments Monday through Friday, 8:30 a.m. to 5 p.m., through September 29, 2015.

Actors should stick to acting, not medical advice

It was about 2002 when someone posted a death threat on the door of my lab.

jim_carey_by_aporelimprevisto-d5fyl39We had done comparative studies of consumer preferences for genetically engineered and conventional crops, and this person didn’t like the results (GE won).

I wasn’t too frazzled — I’m used to being called an asshole — but I had about 15 people working with me and they were, understandably, frazzled.

So we met with campus security – mall cops? – and they advised us on preventative steps.

Anti-vaxxers in the U.S. are employing similar tactics.

According to the Courier Mail, groups campaigning against vital immunization have started going further: harassing, intimidating and smearing the reputations of people who disagree with them.

They have sent their opponents death threats, published their private information online (a practice known as “doxxing”) and sent vicious letters to their employers.

Most disturbing of all, parents have seen their children targeted. A woman belonging to the pro-vaccination group Anti Vax Wall of Shame told Jezebel that her 11-year-old daughter had been sent a threatening Facebook message.

It read: “Your mother is a fat, ugly, lazy piece of s*** who tried to kill you. She is a bully and suffers from mental problems. She is under investigation for the hate groups and illegal computer crimes she’s committing. I hope you like your new home. You can thank me when you’re older.”

The woman said she had also received messages saying her husband had AIDS, her children were ugly and that her kids had rotting teeth.

The administrator of Anti-Vaxxers Wall of Shame, Allison Hagood, has had her address and photo posted in anti-vaxxer Facebook groups, along with comments calling her a “whore.”

Her employer, the University of Colorado, has received emails saying she shouldn’t be allowed to teach psychology. “There’s a core group that are irrational to the point of dangerousness,” said Hagood, who, for her part, insists that no posts on her “mocking” page are threatening or offensive, or identify any of the anti-vaxxers it satirizes.

The frightening trend has ramped up following Thursday’s passing of a Senate Bill called SB 277 by the California assembly, which will end vaccination exemptions on personal or religious grounds.

How about a Canadian angle on Canada Day.

When actor and fellow Canadian Jim Carrey gives advice on medical issues, my response is, stick to acting.

“California Gov says yes to poisoning more children with mercury and aluminum in manditory vaccines. This corporate fascist must be stopped.

Sometimes people with a megaphone go outside their fields of expertise – I’m thinking Linus Pauling and vitamin C.

 

Get vaccinated for hep A before an outbreak: Utah restaurant gets support from customers

Keeping with the Utah theme, Cedar City residents have been heading over to The Pizza Cart to support the restaurant, after a food handler working at the restaurant tested positive for Hepatitis A.

pizza.cartLarisa Banks of Cedar City started an event on Facebook for supporters of the The Pizza Cart to come out and enjoy the restaurant on Friday.

“They have the best pizza and a great atmosphere,” she said. “My husband and I are small business owners in town and it is really hard to see another local business get hurt by something that is really out of their control. We just wanted to show our support.”

Banks said she was offended by some of the comments she heard in town – and on Facebook – and wanted to bring more attention that The Pizza Cart is not to blame.

“The whole thing about this (Hepatitis A) case is that it could have literally happened to anyone,” she said. “Any restaurant in town that has people working for them and handling food, it could have happened to them. The Pizza Cart was super classy with their online news release, they have been up front and honest and they took responsibility for everything, so we should support them for it.”

The Pizza Cart owner Cindy Murray, said, “It is unknown how the employee contracted the virus. However, this employee is recovering and will not be returning to work until medically cleared. All of our other employees have received the Hepatitis A vaccination.”

Charlotte restaurant owner says cost of vaccinating food handlers against hepatitis A worth it

Risk-based decision making is the mantra in food safety. Picking out an intervention is a starts with a numbers game: calculating the prevalence of an action (like handwashing) and matching that with the likelihood of a pathogen in the system. This is the stuff that gets the math nerds like Schaffner excited (me too).

Businesses are faced with cost/risk/benefit decisions daily.ART_vaccine_032711-copy_1

One that’s been debated in food service for over twenty years is whether or not employers or public health folks should require food handlers to be vaccinated for hepatitis A. Authors of a 2000 Journal of Food Protection arrived at the conclusion that the public health benefit of vaccinating for hep A doesn’t equal the costs – but doesn’t factor in all the bad publicity, hassle and incident management costs.

A Charlotte restaurant owner who dealt with a hep A exposure event says the cost to his business was more than the shots, and is suggesting that all food handlers should be vaccinated.

Charlotte restaurant owner is going on the offensive battling perception and health concern over Hepatitis A.

“The restaurant industry is thriving,” said Jon Dressler, owner of three Charlotte-area restaurants.

Last month, however, he received a call no one wants to get.

“We were contacted by the Mecklenburg Health Department that one of our employees had contacted Hep A while on vacation,” said Dressler. “It’s not a cleanliness issue, it’s not an internal issue. The health department didn’t have to shut us down.”

Rather than being upset, Dressler has another idea.

“It would be wonderful if all of Mecklenburg County restaurant workers were required to have the Hep vaccination,” said Dressler.

The National Restaurant Association reports there are 426,000 restaurant workers in North Carolina. The two-set vaccination is about $150 a person.  Meaning, it would cost close to $64 million to vaccinate all restaurant workers in the state.  No one from the state or Mecklenburg County health departments wanted to comment on camera about the need for the vaccine.  However, the CDC did put out a report.

“Slowly, but surely, all of my employees are being vaccinated,” said Dressler.

The restaurant owner isn’t taking chances, making all of his employees get the vaccine.  He admits it’s expensive, but it’s a cost he’s willing to take.

“You weigh the expense of the vaccination versus the expense of any lost business you might incur,” said Dressler.