Additional cases of hepatitis A infection have been reported to the Hawaii State Department of Health (DOH), increasing the number of confirmed cases to 31. DOH staff worked through the holiday weekend to conduct interviews with the newly identified cases in an effort to identify the cause of infection.

“Identifying the source of infection is a challenge,” said State Epidemiologist Dr. Sarah Park. “Hepatitis A has a long incubation period lasting anywhere from two weeks to as long as 50 days. Accurately recalling all of the foods consumed and locations visited during the period when infection could have taken place is challenging for many, especially those who are still feeling ill.”

Patients infected with hepatitis A virus are most contagious during the week before the symptoms start until at least one week after the start of the first symptoms. “Since people are contagious before they feel ill, we are very concerned about the disease unknowingly being spreading to others,” said Health Director Dr. Virginia Pressler.

The virus is found in the stool of people with hepatitis A infection and is usually spread by eating contaminated food or drinking water, and can be spread through close personal or sexual contact. A person who has hepatitis A can easily pass the disease to

others within the same household. For this reason, DOH investigators are currently reaching out to individuals who were in contact with those who have or had hepatitis A.

Hepatitis A vaccine or immune globulin (a substance made from human blood plasma that contains antibodies to protect the body against diseases) administered within the first two weeks after exposure may provide some protection against the disease. Unvaccinated individuals recently exposed to the disease are encouraged to talk to their healthcare providers about these preventive measures.

DOH continues to encourage the public to review their immunization record and talk to their healthcare provider about vaccination. For a list of vaccinating pharmacies, visit or call the Aloha United Way information and referral line at 2-1-1.

While vaccination provides the best protection, frequent handwashing with soap and warm water after using the bathroom, changing a diaper, or before preparing food can help prevent the spread of Hepatitis A. Appropriately cooking and preparing foods can also help prevent infection.

Additional information about hepatitis A can be found on the DOH website at