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Tropical Smoothie Cafe Hepatitis A Outbreak Jumps to 123

statemapArkansas, Maryland, New York, North Carolina, Oregon, Virginia, Wisconsin, West Virginia and CDC, and the U.S. Food and Drug Administration (FDA) are continuing to investigate a multistate outbreak of foodborne hepatitis A. Information available at this time does not indicate an ongoing risk of acquiring hepatitis A virus infection at Tropical Smoothie Café’s, as the contaminated food product has been removed as of August 8. Symptoms of hepatitis A virus infection can take up to 50 days to appear.

As a result, CDC continues to identify cases of hepatitis A related to the initial contaminated product. As of September 14, 2016:

123 people with hepatitis A have been reported from eight states: Arkansas (1), Maryland (12), New York (3), North Carolina (1), Oregon (1), Virginia (98), West Virginia (6), and Wisconsin (1).

47 ill people have been hospitalized. No deaths have been reported.

Epidemiologic and traceback evidence indicate frozen strawberries imported from Egypt are the likely source of this outbreak.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food.  The law firm has brought Hepatitis A lawsuits against such companies as Costco, Subway, McDonald’s, Red Robin, Chipotle, Quiznos and Carl’s Jr.  We proudly represented the family of Donald Rockwell, who died after consuming hepatitis A tainted food and Richard Miller, wo required a liver transplant after eating food at a Chi-Chi’s restaurant.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

Yet Another Restaurant Linked to Hawaii Hepatitis A Outbreak

According to the Hawaii Department of Health employees of the following food service business(es) has been diagnosed with hepatitis A. This list does not indicate these businesses are sources of this outbreak; at this time, no infections have been linked to exposure to these businesses. The likelihood that patrons of these businesses will become infected is very low. However, persons who have consumed food or drink products from these businesses during the identified dates of service should contact their healthcare provider for advice and possible preventive care.

Listed businesses will be removed from this list once 50 days have elapsed from the affected employee’s last service date while potentially infectious. Since the incubation period for hepatitis A is between 15 and 50 days, any customers who were potentially exposed at that business are no longer considered at risk for developing hepatitis A from that exposure after 50 days have passed.

  • Hokkaido Ramen Santouka, Oahu, Honolulu (801 Kaheka Street), July 21-23, 26-30, and August 2-6, 9-11, 2016
  • Papa John’s Waipahu, Oahu, Waipahu (94-1021 Waipahu Street), July 23-24, and August 2, 2016
  • New Lin Fong bakery, Oahu, Chinatown (1132 Maunakea Street), July 20, 22-23, 25, 27, 29-30, and August 1, 3, and 5-6, 2016
  • Hawaiian Airlines, July 31-August 1, August 10-12
  • Zippy’s Restaurant, Oahu, Kapolei (950 Kamokila Boulevard), August 14, 18–19, 21, 23, and 25–26
  • Harbor Restaurant at Pier 38, Oahu, Honolulu (1133 North Nimitz Highway), August 26 through September 12
  • Ohana Seafood at Sam’s Club, Oahu, Pearl City (1000 Kamehameha Highway), August 29 through September 11
  • Chart House Restaurant, located at 1765 Ala Moana Boulevard in Honolulu on Sept. 1–4 and 8–11, 2016

Good Food Store link in Hepatitis A scare

ShowImageEarlier this week, the health department confirmed that a food service worker in Missoula County tested positive for Hepatitis A. While the food service employee was excluded from work during most of the time that they had symptoms, there is a potential for customer exposure because Hepatitis A can be spread before a person has symptoms – before they know they are infectious or ill. To address this possibility, the department is issuing this public notice in conjunction with the Good Food Store, where the employee’s job included preparing foods for the self-serve salad bar. Ready-to-eat-foods such as those found on a salad bar won’t be cooked or washed by the consumer prior to eating and can be a vehicle for contamination.

Hepatitis A is a liver disease caused by a virus that is spread by contaminated food and water, which is why proper food handling, hand washing, and food handler hygiene is important in preventing its spread. The Good Food Store followed proper sick employee exclusion rules and has excellent policies, practices, and facilities for food handling and hand washing.

The Missoula City-County Health Department recommends the following courses of action:

  • If you ate food from the self-serve salad bar at the Good Food Store between August 15 and September 13, please be alert for symptoms of Hepatitis A. Symptoms may include fever, fatigue, loss of appetite, nausea, vomiting, dark urine, clay-colored bowel movements, joint pain, abdominal cramping and jaundice (yellowing of the skin or eyes). If you start to have any of these symptoms, we urge you to contact the health department at 258-3896 or your health care provider.
  • If you ate food from the self-serve salad bar at the Good Food Store within the past two weeks and have not been previously immunized for Hepatitis A, an immunization given within two weeks of exposure may protect you from getting the disease. Please come to the health department or contact your health care provider as soon as possible to discuss immunization options.
  • If you did not eat food from the self-serve salad bar at the Good Food Store, no action is recommended at this time.

     

Update: Tropical Smoothie Hepatitis A Outbreak Hits 115

Several states, CDC, and the U.S. Food and Drug Administration (FDA) are continuing to investigate a multistate outbreak of foodborne hepatitis A. Information available at this time does not indicate an ongoing risk of acquiring hepatitis A virus infection at Tropical Smoothie Café’s, as the contaminated food product has been removed as of August 8. Symptoms of hepatitis A virus infection can take up to 50 days to appear. As a result, CDC continues to identify cases of hepatitis A related to the initial contaminated product.

115 people with hepatitis A have been reported from seven states: Maryland (10), New York (1), North Carolina (1), Oregon (1), Virginia (96), West Virginia (5), and Wisconsin (1). 39 ill people have been hospitalized. No deaths have been reported.

Epidemiologic and traceback evidence indicate frozen strawberries imported from Egypt are the likely source of this outbreak.

In interviews, nearly all ill people interviewed reported drinking smoothies containing strawberries at Tropical Smoothie Café locations prior to August 8 in a limited geographical area, including Maryland, North Carolina, Virginia, and West Virginia.

On August 8, 2016, Tropical Smoothie Café reported that they removed the Egyptian frozen strawberries from their restaurants in Maryland, North Carolina, Virginia, and West Virginia and switched to another supplier.

Hepatitis A:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food.  The law firm has brought Hepatitis A lawsuits against such companies as Costco, Subway, McDonald’s, Red Robin, Chipotle, Quiznos and Carl’s Jr.  We proudly represented the family of Donald Rockwell, who died after consuming hepatitis A tainted food and Richard Miller, wo required a liver transplant after eating food at a Chi-Chi’s restaurant.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

Marler Clark Retained in Matador E. coli Outbreak

Matador+white+logoSeattle King County Public Health is investigating a cluster of five E. coli infections caused by Shiga-toxin producing E. coli (also called STEC) associated with Matador restaurant in Ballard. Four people ate on 8/14 and one person ate on 8/22. Public Health received the first report of illness on 8/22/16 and the most recent case was reported on 9/6/16.  All the people developed symptoms including diarrhea and abdominal cramps. Four people developed bloody diarrhea. Three people had been hospitalized with one person developing a type of kidney injury called hemolytic uremic syndrome (HUS). All five people have recovered.

Laboratory testing (molecular fingerprinting) has determined that all five people have the same strain of STEC bacteria.  Our investigation is in progress but due to food processing equipment cleaning and the possibility of cross contamination that were observed during an inspection by our Environmental Health team, Public Health has temporarily suspended Matador’s food business permit to allow time for thorough cleaning and sanitizing. The restaurant is working cooperatively with Public Health.

Persons who have eaten at Matador and developed diarrhea within 10 days and anyone who develops bloody diarrhea should consult with their healthcare provider to determine if testing is necessary.

What you need to know about E. coli:

Escherichia coli (E. coli) are members of a large group of bacterial germs that inhabit the intestinal tract of humans and other warm-blooded animals (mammals, birds). Newborns have a sterile alimentary tract, which within two days becomes colonized with E. coli.

More than 700 serotypes of E. coli have been identified. Their “O” and “H” antigens on their bodies and flagella distinguish the different E. coli serotypes, respectively. The E. coli serotypes that are responsible for the numerous reports of contaminated foods and beverages are those that produce Shiga toxin (Stx), so called because the toxin is virtually identical to that produced by another bacteria known as Shigella dysenteria type 1 (that also causes bloody diarrhea and hemolytic uremic syndrome [HUS] in emerging countries like Bangladesh) (Griffin & Tauxe, 1991, p. 60, 73). The best-known and most notorious Stx-producing E. coli is E. coli O157:H7. It is important to remember that most kinds of E. coli bacteria do not cause disease in humans, indeed, some are beneficial, and some cause infections other than gastrointestinal infections, such urinary tract infections. This section deals specifically with Stx-producing E. coli, including specifically E. coli O157:H7.

Shiga toxin is one of the most potent toxins known to man, so much so that the Centers for Disease Control and Prevention (CDC) lists it as a potential bioterrorist agent (CDC, n.d.). It seems likely that DNA from Shiga toxin-producing Shigella bacteria was transferred by a bacteriophage (a virus that infects bacteria) to otherwise harmless E. coli bacteria, thereby providing them with the genetic material to produce Shiga toxin.

Although E. coli O157:H7 is responsible for the majority of human illnesses attributed to E. coli, there are additional Stx-producing E. coli (e.g., E. coli O121:H19) that can also cause hemorrhagic colitis and post-diarrheal hemolytic uremic syndrome (D+HUS). HUS is a syndrome that is defined by the trilogy of hemolytic anemia (destruction of red blood cells), thrombocytopenia (low platelet count), and acute kidney failure.

Stx-producing E. coli organisms have several characteristics that make them so dangerous. They are hardy organisms that can survive several weeks on surfaces such as counter tops, and up to a year in some materials like compost. They have a very low infectious dose meaning that only a relatively small number of bacteria (< 50) are needed “to set-up housekeeping” in a victim’s intestinal tract and cause infection.

The Centers for Disease Control and Prevention (CDC) estimates that every year at least 2000 Americans are hospitalized, and about 60 die as a direct result of E. coli infections and its complications. A recent study estimated the annual cost of E. coli O157:H7 illnesses to be $405 million (in 2003 dollars), which included $370 million for premature deaths, $30 million for medical care, and $5 million for lost productivity (Frenzen, Drake, and Angulo, 2005).

E. coli O157:H7 was first recognized as a foodborne pathogen in 1982 during an investigation into an outbreak of hemorrhagic colitis (bloody diarrhea) associated with consumption of contaminated hamburgers (Riley, et al., 1983). The following year, Shiga toxin (Stx), produced by the then little-known E. coli O157:H7, was identified as the real culprit.

In the ten years following the 1982 outbreak, approximately thirty E. coli O157:H7 outbreaks were recorded in the United States (Griffin & Tauxe, 1991). The actual number that occurred is probably much higher because E. coli O157:H7 infections did not become a reportable disease (required to be reported to public health authorities) until 1987 (Keene et al., 1991 p. 60, 73). As a result, only the most geographically concentrated outbreaks would have garnered enough attention to prompt further investigation (Keene et al., 1991 p. 583). It is important to note that only about 10% of infections occur in outbreaks, the rest are sporadic.

The CDC has estimated that 85% of E. coli O157:H7 infections are foodborne in origin (Mead, et al., 1999). In fact, consumption of any food or beverage that becomes contaminated by animal (especially cattle) manure can result in contracting the disease. Foods that have been sources of contamination include ground beef, venison, sausages, dried (non-cooked) salami, unpasteurized milk and cheese, unpasteurized apple juice and cider (Cody, et al., 1999), orange juice, alfalfa and radish sprouts (Breuer, et al., 2001), lettuce, spinach, and water (Friedman, et al., 1999).

E. coli O157:H7 bacteria and other pathogenic E. coli is believed to mostly live in the intestines of cattle (Elder, et al., 2000) but has also been found in the intestines of chickens, deer, sheep, and pigs. A 2003 study on the prevalence of E. coli O157:H7 in livestock at 29 county and three large state agricultural fairs in the United States found that E. coli O157:H7 could be isolated from 13.8% of beef cattle, 5.9% of dairy cattle, 3.6% of pigs, 5.2% of sheep, and 2.8% of goats. Over seven percent of pest fly pools also tested positive for E. coli O157:H7 (Keen et al., 2003). Stx-producing E. coli does not make the animals that carry it ill. The animals are merely the reservoir for the bacteria.

What you need to know about HUS:

The following is a comprehensive description of the hemolytic uremic syndrome (HUS), its symptoms, and the complications and long-term risks associated with HUS.  (A glossary of terms can be found at the bottom of this entry).

Hemolytic uremic syndrome is a severe, life-threatening complication of an E. coli bacterial infection that was first described in 1955, and is now recognized as the most common cause of acute kidney failure in childhood. E. coli O157:H7 is responsible for over 90% of the cases of HUS that develop in North America. In fact, some researchers now believe that E. coli O157:H7 is the only cause of HUS in children. HUS develops when the toxin from E. coli bacteria, known as Shiga-like toxin (SLT) [1,2], enters cells lining the large intestine. The Shiga-toxin triggers a complex cascade of changes in the blood. Cellular debris accumulates within the body’s tiny blood vessels and there is a disruption of the inherent clot-breaking mechanisms. The formation of micro-clots in the blood vessel-rich kidneys leads to impaired kidney function and can cause damage to other major organs.

About ten percent of individuals with E. coli O157:H7 infections (mostly young children) goes on to develop Hemolytic Uremic Syndrome, a severe, potentially life-threatening complication. HUS is an extremely complex process that researchers are still trying to fully explain.

Its three central features describe the essence of Hemolytic Uremic Syndrome: destruction of red blood cells (hemolytic anemia), destruction of platelets (those blood cells responsible for clotting, resulting in low platelet counts, or thrombocytopenia), and acute renal failure. In HUS, renal failure is caused when the nephrons, or filtering units, become occluded (blocked) by micro-thrombi, which are tiny blood clots. In almost all cases, the filtering ability of the kidneys recovers as the body of the patient slowly dissolves the micro-thrombi within the microvessels.

A typical person is born with about one million filtering units, called nephrons, in each kidney. The core of the nephron is a bundle of tiny blood vessels, called a glomerulus, where osmotic exchange allows for the filtration of wastes that eventually collect in the urine and are excreted. During Hemolytic Uremic Syndrome, the lack of blood flow to the nephrons can cause them to die or be damaged, just as heart muscle can die as the result of coronary vessel occlusion during a heart attack. Dead nephrons do not regenerate.

In general, the longer a patient suffers kidney failure, the greater the loss of filtering units as a result. At some point, the damage to the kidneys’ filtering units can be so severe that the patient will, over a period of years, lose kidney function and suffer end-stage renal disease (ESRD), which requires chronic dialysis or transplantation.

HUS can also cause transient or permanent damage to other organs, which include the pancreas, liver, brain, and heart. The essential pathogenic process is the same regardless of the organ affected: microthrombi inhibit necessary blood flow and cause tissue death or damage. During the acute stage of Hemolytic Uremic Syndrome, patients must be carefully monitored for these extra-renal complications. It is very difficult to predict the severity and course of HUS once it initiates.

The active stage of Hemolytic Uremic Syndrome may be defined as that period of time during which there is evidence of hemolysis and the platelet count is less than 100,000. In HUS, the active stage usually lasts an average of six days (range, 2-16 days). It is during the active stage that the complications of HUS per se usually occur.

Several studies have demonstrated that children with HUS who have apparently recovered will develop hypertension, urinary abnormalities and/or renal insufficiency during long-term follow-up.

Children and adolescents with chronic renal failure face a number of complications from the condition, including alterations in calcium and phosphate balance and renal osteodystrophy (softening of the bones, weak bones and bone pain), anemia (low blood cell count that leads to a lack of energy), growth failure (final height as an adult substantially below normal), hypertension (high blood pressure), and other complications.

Renal osteodystrophy (softening of the bones) is an important complication of chronic renal failure. Bone disease is nearly universal in patients with chronic renal failure; in some children, symptoms are minor to absent while others may develop bone pain, skeletal deformities and slipped epiphyses (abnormal shaped bones and abnormal hip bones) and have a propensity for fractures with minor trauma. Treatment of the bone disease associated with chronic renal failure includes control of serum phosphorus and calcium levels with restriction of phosphorus in the diet, supplementation of calcium, the need to take phosphorus binders, and the need to take medications for bone disease.

Anemia is a very common complication of chronic renal failure. The kidneys make a hormone that tells the bone marrow to make red blood cells and this hormone is not produced in sufficient amounts in children with chronic renal failure. Thus, children with chronic renal failure gradually become anemic while their chronic renal failure is slowly progressing. The anemia of chronic renal failure is treated with human recombinant erythropoietin (a shot given under the skin one to three times a week or once every few weeks with a longer acting human recombinant erythropoietin).

Growth failure ultimately leading to short height as an adult is a very common complication of chronic renal failure in children. The mechanisms of growth failure are complex and due to multiple causes. Poorly controlled renal osteodystrophy (bone disease), inadequate nutrition (insufficient intake of adequate calories), chronic acidosis (blood system too acid) and abnormalities of the growth hormone axis (growth hormone deficiency) are each major contributors to poor growth in the child with chronic renal failure. Growth hormone therapy with human recombinant growth hormone has been approved for use in children with chronic renal failure and such therapy has been shown to accelerate growth, induce persistent catch up growth and lead to normal adult height in children with chronic renal failure. Growth hormone therapy requires giving a shot under the skin once a day. Complications of growth hormone therapy are rare but may include glucose intolerance and exacerbation of poorly controlled renal osteodystrophy.

If the patient does not have a living related donor for their first kidney transplant and when they need a second kidney transplant after loss of the first transplant, they will need dialysis until a subsequent transplant can be performed. The patient can be on peritoneal dialysis or on hemodialysis.

Peritoneal dialysis has been a major modality of therapy for chronic renal failure for several years. Continuous Ambulatory Peritoneal Dialysis (CAPD) and automated peritoneal dialysis also called Continuous Cycling Peritoneal Dialysis (CCPD) are the most common forms of dialysis therapy used in children with chronic renal failure. In this form of dialysis, a catheter is placed in the peritoneal cavity (area around the stomach); dialysate (fluid to clean the blood) is placed into the abdomen and changed 4 to 6 times a day. Parents and adolescents are able to perform CAPD/CCPD at home. Peritonitis (infection of the fluid) is a major complication of peritoneal dialysis.

Hemodialysis has also been used for several years for the treatment of chronic renal failure during childhood. During hemodialysis, blood is taken out of the body by a catheter or fistula and circulated in an artificial kidney to clean the blood. Hemodialysis is usually performed three times a week for 3-4 hours each time in a dialysis unit.

Renal transplantation can be from a deceased or a living related donor (parent or sibling who is over the age of 18 who is compatible). Should the patient have a living related donor available to donate a kidney, they can undergo transplantation without the need for dialysis (preemptive transplantation). Should they not have a living related donor, they will likely need to undergo dialysis while on the waiting list for a deceased donor transplant. Fortunately, children have the shortest waiting time on the deceased donor transplant list. The average waiting time for children age 0-17 years is approximately 275-300 days while the average waiting time for patient’s age 18-44 years is approximately 700 days.

Following transplantation, the patient will need to take immunosuppressive medications for the remainder of their life to prevent rejection of the transplanted kidney. Medications used to prevent rejection have considerable side effects. Corticosteroids are commonly used following transplantation. The side effects of corticosteroids are Cushingnoid features (fat deposition around the cheeks and abdomen and back), weight gain, emotional liability, cataracts, decreased growth, osteomalacia and osteonecrosis (softening of the bones and bone pain), hypertension, acne and difficulty in controlling glucose levels. The steroid side effects, particularly the effects on appearance, are difficult for children, especially teenagers, and non compliance do to the side effects of medications is a risk in children; again, particularly teenagers.

Cyclosporine and/or tacrolimus are also commonly used as immunosuppressive medications following transplantation. Side effects of these drugs include hirsutism (increased hair growth), gum hypertrophy, interstitial fibrosis in the kidney (damage to the kidney), as well as other complications. Meclophenalate is also commonly used after transplantation (sometimes imuran is used); each of these drugs can cause a low white blood cell count and increased susceptibility to infection. Many other immunosuppressive medications and other medications (anti-hypertensive agents, anti-acids, etc) are prescribed in the postoperative period.

Life long immunosuppression, as used in patients with kidney transplants, is associated with several complications including an increased susceptibility to infection, accelerated atherosclerosis (hardening of the arteries), increased incidence of malignancy (cancer) and chronic rejection of the kidney.

United States Renal Data Systems (USRDS) report that the half-life (time at which 50% of the kidneys are still functioning and 50% have stopped functioning) is 10.5 years for a deceased transplant in children age 0-17 years and 15.5 years for a living related transplant in children 0-17 years. Similar data for a transplant at age 18 to 44 years is 10.1 years and 16.0 years for a deceased donor and a living related donor, respectively. Thus, depending upon the age when the patient receives their first transplant they may need 2-3 transplants over the course of their life.

Thus, the life expectancy of a person with a kidney transplant is significantly less than the general population and the life expectancy of a person on dialysis is markedly less than the general population.

Children who appear to have recovered from HUS may develop late complications. A precise determination of the risk of late complications is not likely. It is important to note that the risks of longer term (more than 20 years) complications are unknown and are likely to be higher than risks at 10 years, as many of the above studies describe.

A nephrologist—a kidney specialist—should formally evaluate all persons who have experienced HUSat a year following their acute illness. Kidneys injured by HUS may slowly recover function over at least a six-month period following the acute episode and perhaps longer. Even persons with “mild” HUS who did not require dialysis should be formally evaluated. Such an evaluation should include a routine physical, blood pressure measurement, and blood and urine analyses from which kidney filtration rate can be calculated.

Studies done to date on HUS outcomes have largely confirmed a positive correlation between more severe kidney involvement acutely, particularly the need for extended dialysis, and increased incidence of future renal complications. However, it has been shown in multiple studies that even moderate kidney compromise in the acute phase of HUS can result in long-term complications due to damage to the filtering units in the kidneys.

Among survivors of HUS, estimates are that about five percent will eventually develop end stage kidney disease, with the resultant need for dialysis or transplantation, and another five to ten percent experience neurological or pancreatic problems which significantly impair quality of life. Since the longest available follow-up studies of HUS are about twenty (20) years, an accurate lifetime prognosis is not available, and as such, medical follow-up is indicated for even the mildest affected cases.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of E. coli outbreaks and hemolytic uremic syndrome (HUS). The E. coli lawyers of Marler Clark have represented thousands of victims of E. coli and other foodborne illness infections and have recovered over $600 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our E. coli lawyers have litigated E. coli and HUS cases stemming from outbreaks traced to ground beef, raw milk, lettuce, spinach, sprouts, and other food products.  The law firm has brought E. coli lawsuits against such companies as Jack in the Box, Dole, ConAgra, Cargill, and Jimmy John’s.  We have proudly represented such victims as Brianne Kiner, Stephanie Smith and Linda Rivera.

If you or a family member became ill with an E. coli infection or HUS after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark E. coli attorneys for a free case evaluation.

Hawaii Hepatitis A Class Action Filed

Starn O’Toole Marcus & Fisher, a Honolulu law firm in partnership with leading foodborne illness lawyer Bill Marler, has filed a second class action lawsuit as a result of the Hepatitis A outbreak in Hawaii. The suit names as defendants Genki Sushi, Koha Foods and Sea Port Products as the sources of the contaminated food. Complaint

The class of plaintiffs includes all persons who consumed food or drink at restaurants (and other outlets where food may be purchased and consumed), where employees were involved in the preparation and sale of food. This includes other restaurants, markets and airline flights during the identified time periods. Following the recommendations of public health officials or other medical personnel, the class obtained a Hepatitis A vaccination to prevent HAV infection. The class does not include those who developed HAV infections.

People who believe they should be included in this class action may send an email to hepaclass-action@starnlaw.com, or visit hawaiihepatitisclassaction.com

Trevor Brown of Starn O’Toole Marcus and Fisher commented, “This action seeks to compen- sate people who were exposed to the second wave of Hep A, and took appropriate action to pro- tect themselves and to protect others from the continued spread of the virus.“

Bill Marler, of Marler Clark said, “The lawsuit underscores why it is so vitally important that all food service workers be vaccinated against Hepatitis A.”

For more information or to speak to one of the lawyers contact Starn O’Toole Marcus & Fisher at 808-537-6100 and ask for Judith Pavey or Trevor Brown.

Restaurants and Food Outlets Identified as of September 6, 2016

Baskin Robbins, Waikele Center, June 17-19, 21-22, 25, 27, 30 and July 1,3, 2016

Chili’s, Kapolei (590 Farrington Hwy), July 10,12,14,15,17,18, 20-23, 25-27, 2016

Costco Bakery, Hawaii Kai, June 16-20, 2016

Hawaiian Airlines July 31, 2016 August 1, 2016 August 10, 2016 August 12, 2016
Flight HA22 from Honolulu, HI (HNL) to Seattle, WA (SEA), Flight HA21 from Seattle, WA (SEA) to Honolulu, HI (HNL), Flight HA18 from Honolulu, HI (HNL) to Las Vegas, NV (LAS), Flight HA17 from Las Vegas, NV (LAS) to Honolulu, HI (HNL)

Hokkaido Ramen Santouka, Honolulu (801 Kaheka Street), July 21-23, 26-30, and August 2-6, 9-11, 2016

Taco Bell, Waipio (94-790 Ukee Street), June 16, 17, 20, 21, 24, 25, 28-30, and July 1, 3, 4, 6, 7, and 11, 2016

Tamashiro Market, Kalihi (802 N. King Street), July 2, 4, 6-8, 11-13, 15-19, and 23, 2016

Papa John’s, Waipahu, (94-1021 Waipahu Street), July 23-24, and Aug. 2, 2016

New Lin Fong bakery, Chinatown, (1132 Maunakea Street), July 20, 22-23, 25, 27, 29-30, and Aug. 1, 3, and 5-6, 2016

Zippy’s Restaurant, Kapolei (950 Kamokila Boulevard), August 14, 18-19, 21, 23 and 25 -26

Sushi Shiono, Waikoloa Beach Resort, Queen’s MarketPlace (69-201 Waikoloa Beach Drive), July 5-8, 11-15, and 18-21, 2016

Hepatitis A:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food.  The law firm has brought Hepatitis A lawsuits against such companies as Costco, Subway, McDonald’s, Red Robin, Chipotle, Quiznos and Carl’s Jr.  We proudly represented the family of Donald Rockwell, who died after consuming hepatitis A tainted food and Richard Miller, wo required a liver transplant after eating food at a Chi-Chi’s restaurant.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

Tropical Smoothie Cafe Hepatitis A Outbreak Hits 85

statemap1Several states, CDC, and the U.S. Food and Drug Administration(FDA) are investigating a multistate outbreak of foodborne hepatitis A.

85 people with hepatitis A have been reported from seven states: Maryland (6), New York (1), North Carolina (1), Oregon (1), Virginia (70), West Virginia (5), and Wisconsin (1).

32 ill people have been hospitalized. No deaths have been reported.

Epidemiologic and traceback evidence indicate frozen strawberries imported from Egypt are the likely source of this outbreak.

In interviews, nearly all ill people interviewed reported drinking smoothies containing strawberries at Tropical Smoothie Café locations in a limited geographical area, including Maryland, North Carolina, Virginia, and West Virginia.

Tropical Smoothie Café Hepatitis A Outbreak Hits 74 in Maryland, New York, North Carolina, Oregon, Virginia, West Virginia, and Wisconsin

statemapThe CDC, and the U.S. Food and Drug Administration (FDA) are investigating a multistate outbreak of foodborne hepatitis A.  74 people with hepatitis A have been reported from seven states: Maryland (6), New York (1), North Carolina (1), Oregon (1), Virginia (59), West Virginia (5), and Wisconsin (1).  32 ill people have been hospitalized. No deaths have been reported. Epidemiologic and traceback evidence indicate frozen strawberries imported from Egypt are the likely source of this outbreak.

On August 8, 2016, Tropical Smoothie Café reported that they removed the Egyptian frozen strawberries from their restaurants in Maryland, North Carolina, Virginia, and West Virginia and switched to another supplier. Out of an abundance of caution, Tropical Smoothie Café has since switched to another supplier for all restaurants nationwide.

Contact your doctor if you think you may have become ill from eating a smoothie containing strawberries from a Tropical Smoothie Café prior to August 8, 2016 in the following states:

  • Virginia
  • West Virginia
  • Maryland
  • North Carolina

It is important that food handlers and restaurant employees contact their doctor and stay home if they are infected with hepatitis A. This helps prevent the virus from spreading. Not everyone will experience symptoms from a hepatitis A virus infection. Some people may experience mild flu-like symptoms. Other symptoms of hepatitis A virus infection include:

  • Yellow eyes or skin
  • Abdominal pain
  • Pale stools
  • Dark urine

Hepatitis A:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food.  The law firm has brought Hepatitis A lawsuits against such companies as Subway, McDonald’s, Chipotle, Quiznos and Carl’s Jr.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

66 Sick with Hepatitis in Virginia, West Virginia, Maryland, North Carolina, Oregon and Wisconsin

According to press reports and the CDC, Hepatitis A cases linked to Tropical Smoothie Café have been identified in five other states besides Virginia, bringing the total number of cases to 66.

Maryland and West Virginia are now reporting four cases each; North Carolina, Oregon and Wisconsin are each reporting one case.

55 Virginia residents who had tested positive for hepatitis A (28 in Northern, 9 in Northwest, 12 in Eastern, 6 in Central, 0 in southwest) reported consuming a smoothie at Tropical Smoothie Café prior to becoming ill.

Approximately 46% of the residents, for whom information is available, have been hospitalized for their illness. The 55 ill residents range in age from 14-68. Onsets of illness for the 55 cases range from early May through August.

Hepatitis A:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food.  The law firm has brought Hepatitis A lawsuits against such companies as Subway, McDonald’s, Chipotle, Quiznos and Carl’s Jr.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.

Genki Sushi Scallops Hepatitis A Outbreak Grows – Lawsuits Filed

As of August 22, 20116, the HDOH has identified 22 new cases of hepatitis A.  All cases have been in adults, 58 have required hospitalization. Findings of the investigation suggest that the source of the outbreak is focused on Oahu. Eleven (11) individuals are residents of the islands of Hawaii, Kauai, or Maui, and three visitors have returned to the mainland.  There are now 228 cases. Onset of illness has ranged between 6/12/16 – 8/16/16.

On August 15, 2016, HDOH identified raw scallops served at Genki Sushi restaurants on Oahu and Kauai as a likely source of the ongoing outbreak. The product of concern is Sea Port Bay Scallops (Wild Harvest, Raw Frozen) that originated in the Philippines (states “Product of the Philippines” on the box), distributed by Koha Oriental Foods and True World Foods. As a result, HDOH ordered this product embargoed (not to be sold, purchased, or consumed) throughout the state, and the temporary closure of all Genki Sushi restaurants on Oahu and Kauai. The scallops received by True World Foods have not been distributed to any restaurants in the state, and were embargoed at their warehouse. The scallops served at Genki locations on the Big Island and Maui originated from a different supplier and have not been associated with the outbreak.

The outbreak investigation is ongoing.   It continues to be challenging because of the long incubation period of the disease (15 to 50 days) and the difficulty patients have in accurately recalling the foods consumed and locations visited during the period when infection could have taken place.

Healthcare providers have been informed and are asked to notify HDOH immediately if they have a patient they suspect may be infected.

HDOH encourages Hawaii residents to consider getting vaccinated for hepatitis A, and advises that they talk to their healthcare provider about hepatitis A if they are interested. Vaccination for hepatitis A is strongly recommended for certain individuals who are especially at risk (see HERE for a CDC list of groups recommended to be vaccinated for hepatitis A).

Hawaii residents are also advised that the demand for the vaccine during the outbreak has led to varied supply levels around the state, so it is recommended that they call ahead to assure the vaccine is available at a particular clinic or pharmacy before going there.

Hepatitis A:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food.  The law firm has brought Hepatitis A lawsuits against such companies as Costco, Subway, McDonald’s, Red Robin, Chipotle, Quiznos and Carl’s Jr.  We proudly represented the family of Donald Rockwell, who died after consuming hepatitis A tainted food and Richard Miller, wo required a liver transplant after eating food at a Chi-Chi’s restaurant.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.