Michigan health officials say the southeast part of the state is seeing a serious outbreak of hepatitis A cases.

An analysis by the Detroit Free Press found that Michigan has led the U.S. in hepatitis cases per capita this year, with more than 500 reported cases so far.

The Detroit News reports that there have been 20 deaths linked with hepatitis A in southeast Michigan since August 2016.

The Centers for Disease Control and Prevention says hepatitis A is an extremely contagious liver disease caused by the hepatitis A virus. It can be spread during sex or by eating contaminated food or water.

Health officials say the majority of cases involve drug users, homeless people and current or former inmates. The outbreak has particularly affected Wayne, Macomb and Oakland counties.

The Monroe News reports a case of hepatitis A has been confirmed in Monroe County. According to the paper, the employee works at the Tim Hortons at 404 S. Monroe St. The health department says anyone who ate or drank at the restaurant between Nov. 21 and Dec. 8 may have been exposed and should talk to a doctor. Anyone who may have been exposed may need a hepatitis A vaccination or immune globulin treatment.

Michigan health officials are urging customers who consumed food or beverages at two Detroit-area pizzerias to get vaccinated against hepatitis A after workers there tested positive for the liver disease.

The Detroit Health Department said Tuesday it’s investigating a case at Paul’s Pizza on West Vernor in Detroit and urges vaccinations by Friday for anyone who dined at the restaurant between Nov. 20 and Nov. 25.

Also, Oakland County’s Health Division said it has confirmed a case at Papa Romano’s pizzeria on Nine Mile at Telegraph Road in Southfield and urge vaccinations by before Sunday for anyone who dined there between Nov. 22 and Nov. 26.

The two cases are the latest in a hepatitis A outbreak in Michigan. State health officials confirm more than 550 cases, including 20 deaths, since Aug. 1, 2016.

A worker at Andy’s Pizza, 13280 North Line Road, in Southgate was confirmed to have Hepatitis A while working at the restaurant between Nov. 3 and 17.

The Wayne County Department of Health, Veteran and Community Wellness confirmed Dec. 1.

Once the illness was confirmed the employee was removed from the restaurant, and it was thoroughly cleaned.

“We have been working side-by-side with the health department and have been cleared to stay open after inspections and the staff receiving the vaccine, as a precautionary measure,” owners posted on the store’s Facebook page. “We would not be allowed to operate under Wayne County health department laws if there was a possible risk of contaminating the public. The person who had the virus that work for us as of 2 weeks ago is no longer working in the establishment and contracted the virus from outside of Andy’s. The employee was put into immediate isolation. We apologize for any Inconvenience or the lack of confidence in any of our customers faith in our operation.”

Wayne County officials are urging anyone who ate at the restaurant during that time to watch for abdominal pain, nausea, vomiting, diarrhea, dark urine, clay-colored stool, fever, chills, yellow skin and eyes, all of which are symptoms of the illness. Symptoms typically show up between 15 and 50 days of contact.

Hepatitis A can be fatal.

County officials said all residents should get vacinated if it is medically feasible for them.

For those without insurance coverage, the vaccine is available at the Wayne County Health Department Clinic, located at 33030 Van Born Rd. in Wayne, Michigan.

To find out more information about hepatitis A, visit www.michigan.gov/hepatitisaoutbreak or call Wayne County at 734-727-7078.

A Greektown Casino employee has been diagnosed with Hepatitis A, the Detroit Health Department said Thursday, just two days after it announced a separate case in Detroit.

The department said it believes there is no suspected risk for casino patrons other than those who consumed food or beverages in the private Platinum member card access area between Nov. 11 and Nov. 22.

According to a news release, Greektown Casino, located at 555 East Lafayette, is attempting to those patrons to urge them to obtain a vaccination.

As of Thursday, only one Greektown employee is known to have Hepatitis A.

The health department said the risk of transmission of Hepatitis A from an employee is usually low.  Hepatitis A can potentially be prevented if given a vaccination within two weeks of having come in with the virus. Given the low, but potential risk, the Detroit Health Department is recommending vaccination for people who may have eaten in the private Platinum member card access area during the exposure period.

The Detroit Health Department has also notified the casino that the affected employee cannot return to work until cleared by their doctor.

“We are diligently working with our state partners, physicians, hospitals, food establishments, and community groups to educate the community, limit any potential exposures, and vaccinate those who are at risk,” said Dr. Joneigh Khaldun, Director and Health Officer of the Detroit Health Department.

Greektown CEO Jason Gregorec said in a statement that the safety of the casino’s guest and employees is of the “utmost importance.”

“It is significant to note that while no one else has reported any illness, we are taking all precautions to make certain that the incident remains isolated,” Gregorec said.

The news comes two days after a Detroit resident who works as a crew member at a McDonald’s on West Grand Boulevard was diagnosed with Hepatitis A.

The Detroit Health Department issued a news release saying it is conducting a thorough investigation at the McDonald’s, which is located at 2889 West Grand Blvd., to ensure appropriate food handing and cleaning protocols are being followed.

I have been advocating this for a very long time.

As recently reported, the Monroe County Health Department (MCHD) and the Michigan Department of Health and Human Services (MDHHS) are continuing to see an increased number of Hepatitis A cases in the City of Detroit, Lapeer, Livingston, Macomb, Monroe, Oakland, St. Clair, Sanilac, Washtenaw, and Wayne counties. There has been an increase in the infection among food workers, both in restaurants and other food preparation venues. Hepatitis A is easily transmitted by consuming food or beverages handled by infected persons. Each ill food-worker situation could present a significant risk of infection to large numbers of people. It is important to note that there have been no Monroe County food-service facilities/workers connected to the outbreak at this point.

What is Hepatitis A?

Hepatitis A is a contagious liver disease that occurs as a result of infection with Hepatitis A virus. Symptoms include fatigue, fever, loss of appetite, abdominal pain, nausea and vomiting, jaundice (yellowing of skin and eyes), abnormal liver tests, dark urine and pale stools. Most cases recover completely with no ill effects. Hepatitis A can be contracted by eating contaminated food or water, sexually, or just by living with an infected person. Illness can appear 15-50 days after exposure and individuals can be sick for several weeks.

What can food service workers do to protect themselves and their communities?

All licensed food-service facilities recently received an informational letter from the Michigan Department of Agriculture and Rural Development (MDARD) regarding Hepatitis A, its effects and how transmission can be prevented.

If you have health insurance, contact your health care provider or pharmacy for the Hepatitis A vaccine. Otherwise, in an attempt to prevent further outbreak in Monroe County, the Health Department will be providing immunization to all food- service workers who have not previously been vaccinated for Hepatitis A.

The MCHD will be hosting FREE Hepatitis A immunization clinics beginning Monday, December 4, 2017. The clinics will be held Monday, Tuesday, Thursday and Friday from 8:30 A.M.-11:30 A.M. and 1 P.M. – 4:30 P.M. Wednesday clinics will run from 10:00 A.M. – 11:30 A.M. and 1:30 P.M. – 6:30 P.M. The clinics will be on a walk-in basis (no appointment necessary) and will run through December 15.

“It is important for all food-service employees in Monroe County to realize the enormous impact they can have on preventing the spread of this potentially dangerous virus. The MCHD strongly encourages all employees to get vaccinated, including but not limited to: cooks, prep cooks, dishwashers, servers, dining room attendants, hosts/hostesses, managers and owners” said Chris Westover, Environmental Health Director at the Health Department. “Furthermore, this free clinic is not limited to restaurants only. It is open to any and all employees who prep, cook, handle or serve food at any point in the work day. This includes grocery stores, convenience stores, delicatessens, party stores, food processors, etc.”, he added.

For more information regarding the free Hepatitis A vaccine clinics, please call the Monroe County Health Department at 734-240-7800, Bridget Huss at 734-240-7831 or Chris Westover at 734-240-7921.

The Detroit Free Press reports that a Detroit resident who works as a crew member at a McDonald’s on West Grand Boulevard has been diagnosed with Hepatitis A, according to the Detroit Health Department which is investigating the case.

The Detroit Health Department issued a news release saying it is conducting a thorough investigation at the McDonald’s, which is located at 2889 West Grand Blvd., to ensure appropriate food handing and cleaning protocols are being followed.

Individuals who ate at the restaurant between Nov. 8 and Nov. 22 are being urged to get a Hepatitis A vaccinebefore Dec. 6.

Generally, the risk of transmission of Hepatitis A from an infected food handler is low. Hepatitis A can potentially be prevented if you are given a vaccination after having come in contact with the virus. After exposure, vaccination is most effective within two weeks.

As We said before – “For Goodness Sake – Vaccinate”

Management of Champs Rotisserie and Spirits at 20515 Mack Ave. alerted the Wayne County Department of Health, Veterans and Community Wellness to the issue.

Hepatitis A is spread through contaminated food or water, or close personal contact with an infected person.

The ill employee is not working and is receiving medical care, the health department said in a news release.

Health officials say those who ate food from the restaurant on or after Oct. 20 should get a vaccine by Nov. 13 if they have not already been vaccinated. People who consumed food from the restaurant Oct. 10-30 should watch for symptoms of hepatitis A, which can include abdominal pain, nausea, vomiting, diarrhea, dark urine, clay colored stool, fever, chills and jaundice. Symptoms occur 15-50 days after exposure and can last for several weeks to months.

Since Aug. 1, 2016, there have been 486 cases of hepatitis A, including 19 fatalities,  identified as related to an outbreak in Southeast Michigan, according to the Michigan Department of Health and Human Services.

In October, health officials said they were investigating cases at Firewater Bar and Grill and a Little Caesars Pizza location in Detroit and a restaurant worker in Ann Arbor. Cases last year were linked to Whole Foods in Detroit and Social Kitchen in Birmingham.

An employee at Trader Joe’s in Reno has contracted Hepatitis A and the store has had to post notices to inform customers.

Washoe District Health Department spokesman Phil Ulibarri said the store notified the health department of the infected employee in early November, as required by law.

The employee worked as both a stocker and a checker. As a stocker, the employee wore gloves, but as a checker did not, so there was a potential for exposure, Ulibarri said.

The Reno Trader Joe’s referred questions to corporate offices and no one was available.

The Centers for Disease Control said Hepatitis A is a liver infection transmitted orally or by consuming contaminated food or water.

Symptoms include fatigue, low appetite, stomach pain, nausea, and jaundice and usually ends within two months of infection.

The Kentucky DPH says a total of 31 cases of acute hepatitis A cases have been reported in Kentucky throughout 2017, which is about a 50 percent increase from the average number of cases per year in the state. The illness is serious, and the DPH says it can be life-threatening. It is often spread when people do not wash their hands properly or by eating uncooked or under-cooked food.

Jefferson County has had 19 confirmed cases, and most have happened since August. In addition to Jefferson and McCracken, cases have been reported in Jefferson, Shelby, Bullitt, Hardin, Henry, Anderson, Mason, Christian, Madison, Fayette, McCracken, Hopkins, and Leslie counties.

No deaths have been attributed to the outbreak, but the DPH says if you have symptoms, you are urged to contact your health care provider to be tested and treated if needed. Symptoms include jaundice (yellowing of the skin or eyes), dark-colored urine, fatigue, abdominal pain, loss of appetite, nausea, diarrhea, vomiting, fever and gray stool.

Kids 1-18 recommended to get the hepatitis A vaccine, as well as adults who have increased risk factors or certain medical conditions. Otherwise, the best ways to keep from getting hepatitis A are to wash your hands thoroughly with warm water and soap, handle uncooked food properly and fully cook your food. The DPH says always wash your hands before eating or touching food and after using the toilet or changing a diaper. Use hand sanitizing gels and wipes if you don’t have access to soap and water.

Since January 1, 2017, Utah public health has identified 84 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. For more information on hepatitis A, click here.

Last updated 11/13/17

Outbreak-Associated Cases 75
Onset Date Range 5/8/2017 – 11/08/2017
Age Range 22 – 69 years    median age 40 years
Sex
Male 48 64.0%
Female 27 36.%
Health Jurisdictions
Salt Lake County 57 76.0%
Utah County 11 14.7%
Bear River   4   5.3%
Central   1   1.3%
Southwest Utah   2   2.7%
Hospitalization 44 58.7%
Deaths   0  0.0%
Risk Factors
Homelessness and Drug Use 36 48.0%
Drug Use 15 20.0%
Homelessness   6   8.0%
Epi-Linked 10 13.3%
Travel   2   2.7%
Unknown   6   8.0%
Incarcerated 17 22.7%

News reports that customers may have been exposed to hepatitis A at a Costco in Montebello, health officials said Friday.

The Los Angeles County Department of Public Health said in a statement there was a “possible low risk” of exposure to the deadly virus. Butchered meat and seafood products sold at the store, 1345 N. Montebello Ave., between Oct. 22 and Oct. 31 may have been contaminated by a worker with hepatitis A.

Hepatitis A is a liver disease with symptoms that include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and a yellowing of the skin or eyes or jaundice. In extreme cases, the virus can cause liver failure and even death.

The Department of Public Health is working with Costco to investigate the possible exposure and provide employees with hepatitis A vaccines, according to the statement.

The department is recommending that individuals who handled or consumed the meat and seafood products from the Montebello Costco get vaccinated or receive an immune globulin shot by Mondayto prevent or reduce illness. They should also discard any leftover meat and seafood purchased between Oct. 22 and Oct. 31.

Costco is offering free hepatitis A vaccinations at the Montebello store for any customers who may have handled or consumed the meat and seafood products that may have been contaminated.

Here are the times the vaccines are offered:

  • 9:30 a.m. to 6 p.m. Saturday, Nov. 11
  • 10 a.m. to 6 p.m. Sunday, Nov. 12
  • 9:30 a.m. to 6 p.m. Monday, Nov. 13

The Department of Public Health routinely sees cases of hepatitis A. Over the past five years, there have been between 35 and 60 confirmed cases each year.

For more information on hepatitis A, go to www.publichealth.lacounty.gov or call the county information line at 211.