The Utah Department of Health reported that two restaurants are linked to an ongoing hepatitis A outbreak in Utah County and other parts of the state since August.  This on top of a 7-11 earlier this month.

Anyone who ate, drank or used the restroom at Sonic Drive-In or Olive Garden in Spanish Fork on certain days in December may have been exposed to hepatitis A, health officials warn. An infected employee was working at those locations at the time, the department said. It warns that symptoms don’t show up immediately and it is important to get a vaccine as soon as possible.

Those at risk visited Sonic on North Main Street on Dec. 23 or 24, or Olive Garden on North Canyon Creek Parkway anytime from Dec. 21-30, the Utah County Health Department said in a prepared statement Tuesday evening.

The department is making vaccinations available to those who may have been exposed to the disease.

The health department encouraged businesses that serve food to vaccinate employees.

Since January 1, 2017, Utah public health has identified 152 confirmed cases of hepatitis A virus (HAV) infection; many among persons who are homeless and/or using illicit drugs. Several cases have been linked by investigation and/or viral sequencing to a national outbreak of hepatitis A involving cases in California and Arizona. Hospitalization rates of less than 40% have been described in previous hepatitis A outbreaks; however, other jurisdictions associated with this outbreak are reporting case hospitalization rates approaching 70%. The high rate of hospitalization may be a result of cases having underlying illnesses (e.g., alcoholism), or a higher rate of hepatitis comorbidities (e.g., hepatitis B or C). In response to the outbreak, public health officials have been working to identify cases and contacts, provide education, and ensure opportunities for vaccination of close contacts to cases and vulnerable populations.

Hepatitis A is usually spread through having oral contact with items contaminated with hepatitis A, for example, through ingesting food or drinks contaminated by infected feces. Some people do not develop symptoms, even if infected. If symptoms occur, they usually appear anywhere from 2-6 weeks after exposure. Symptoms usually develop over a period of several days, and may include jaundice (the yellowing of the skin or whites of the eyes), abdominal pain, nausea or diarrhea. Hepatitis A vaccination is the best way to prevent hepatitis A infection.