Food Poisoning Watch

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Utah public health officials are investigating an increase in Shiga toxin-producing Escherichia coli (STEC) infections across the state. While the source of these infections has not been identified, several ill individuals reported visiting petting zoos, corn mazes, and farms.

Since October 1, 2018, 20 cases of STEC have been reported along the Wasatch Front and in the Central and Southwestern regions of Utah. Cases range in age from 10 months to 71 years old. Eleven cases are younger than 18. Six people were hospitalized and no deaths have been reported. “For the past five years, Utah has averaged about 13 cases of STEC during the month of October,” said Kenneth Davis, epidemiologist with the Utah Department of Health (UDOH). “An average of 113 STEC cases and 25 hospitalizations are reported each year in Utah. This increase in October is higher than normally expected,” said Davis. UDOH is working with Utah’s local health departments to investigate the illnesses and determine the source of infection.

E. coli is a bacteria spread by consuming contaminated food or water, unpasteurized (raw) milk, contact with cattle, or contact with the feces of infected people. People visiting petting zoos and areas where cattle have been are at greater risk of contracting E. coli, especially if they are not practicing good hand hygiene. Symptoms usually appear 3–4 days after exposure and can vary, but often include severe stomach cramps, diarrhea (often bloody), and vomiting. Most people get better within 5–7 days, but some infections are severe or even life-threatening. Hemolytic uremic syndrome (HUS), a type of kidney failure, is a potentially life-threatening complication of E. coli infection. Very young children and the elderly are more likely to develop severe illness and kidney failure than others, but even healthy, older children and young adults can become seriously ill.

Practicing good hand hygiene is one of the best ways to reduce your chance of getting and spreading E. coli infection. Always wash your hands:

  • Before and after preparing or eating food
  • After using the bathroom or changing diapers
  • After touching or being around animals or places where animal feces may be present (e.g., farms, petting zoos, fairs, corn mazes, or even your own backyard)

Other protective measures include:

  • Stay home from school or work while you have diarrhea. Most people can return to work or school when they no longer have diarrhea, but special precautions are necessary for food handlers, healthcare workers, and childcare providers and attendees. Check with your employer before returning to work, and check with your child’s child care center before resuming child care.
  • Follow the four steps to food safety when preparing food: clean, separate, cook, and chill.
  • Avoid raw (unpasteurized) milk, unpasteurized dairy products, and unpasteurized juices (such as fresh apple cider).
  • Don’t swallow water when swimming and when playing in lakes, ponds, streams, swimming pools, backyard “kiddie” pools, and splash parks.

Contact your healthcare provider if you have diarrhea that lasts for more than three days, or is accompanied by high fever, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine. Antibiotics should not be used to treat this infection. There is no evidence that treatment with antibiotics is helpful, and taking antibiotics may increase the risk of HUS. Antidiarrheal agents may also increase that risk.

Customers who ate at New Yorker Restaurant in Salt Lake between July 25 and Aug. 15 may have been exposed to hepatitis A, health officials said Monday.

An employee at the restaurant, located at 60 West Market St., potentially handled certain food or beverages while infected, Salt Lake County Health Department spokesman Nicholas Rupp said in an emailed statement.

The possible exposure affects only the New Yorker Restaurant, Rupp said. Officials estimate about 650 people may have been exposed.

“It is too late for people who consumed items at the restaurant between the dates listed to receive preventive vaccination, so those individuals should watch for symptoms of hepatitis A and see their health care provider if they are concerned,” Rupp said in the statement.

Hepatitis A is a highly-contagious liver disease that can be transmitted person-to-person or through contaminated food or beverages, according to the Centers for Disease Control. Symptoms of hepatitis A include a low fever, fatigue, loss of appetite, nausea, vomiting and yellow skin and eyes, health department officials said. The incubation period for the virus is two to seven weeks, so potentially affected customers should watch for symptoms until Oct. 3.

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 $650 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, who 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.

Three Rivers District Health Department (TRDHD) service area comprised of Carroll, Gallatin, Owen and Pendleton counties strongly encourages hepatitis A vaccination for all our residents.

TRDHD has been implementing efforts to control the spread of the virus over the past several months and will continue to expand its efforts with vaccinating the at risk populations and advising health care providers, detention centers, food service establishments, and agencies that serve the homeless and people with substance use disorders. Of particular concern is a case of hepatitis A that has been diagnosed in an employee who handled food at the Owenton McDonald’s (506 South Main Street). An investigation found that this employee worked during a period of time when he/she was ill or infectious, which included the dates of August 16 through August 27, 2018.

While it is relatively uncommon for restaurant patrons to become infected with the hepatitis A virus due to an infected food handler, anyone who consumed food or drink at the Owenton McDonald’s during the stated time period is advised to get a hepatitis A vaccination. This is recommended whether the patrons live in Owen County or elsewhere. Vaccination is effective in protecting an individual from becoming infected if received within two weeks of exposure to the virus. If it has been longer than two weeks, vaccination is still recommended for future protection.

In addition, anyone who consumed food or drink at the Owenton McDonald’s during the dates listed should monitor their health for symptoms of hepatitis A infection for 50 days from their visit; wash their hands with soap and warm water frequently and thoroughly, especially after using the bathroom and before preparing food. If symptoms of hepatitis A infection develop, they should contact their healthcare provider immediately and stay at home until given further instructions by their doctor.

Hepatitis A is a viral infection of the liver that can cause loss of appetite, nausea, tiredness, fever, stomach pain, brown-colored urine, light-colored stools and diarrhea. Yellowing of the skin or eyes (jaundice) may also appear. People may have some or none of these symptoms. It could take almost seven weeks after being exposed to the virus for someone to become ill. Someone sick with hepatitis A is most likely to spread the virus during the 2 weeks before feeling sick and for 1 week after yellow eyes and skin starts. Children often do not exhibit symptoms. Although rare, death can occur from this infection. Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food or drinks contaminated by small, undetected amounts of stool from an infected person. The virus spreads when an infected person does not wash his/her hands adequately after using the toilet or engages in behaviors that increase the risk of infection. Consistent and careful hand washing, including under the fingernails, for at least 20 seconds with soap and water, along with vaccination of anyone at risk of infection, will help prevent the spread of this disease.

For goodness sake, vaccinate – your employees!

The Arkansas Department of Health (ADH) is warning of a possible hepatitis A (hep A) exposure after an employee of the Little Caesar’s Pizza, at 1731 West Kingshighway in Paragould, tested positive for the virus. Hep A is a contagious liver disease.

Anyone who ate at this facility from July 19 to August 2 should seek vaccination immediately if they have never been vaccinated against hep A or are unsure of their vaccination status. There are no specific treatments once a person gets hep A. Illness can be prevented even after exposure by getting the vaccine or medicine called immune globulin. This medicine contains antibodies to hep A and works best if given within two weeks of exposure to the virus.

The Arkansas Department of Health (ADH) is warning of a possible hepatitis A (hep A) exposure after an employee of the Red Lobster, at 7401 Rogers Ave. in Fort Smith tested positive for the virus. Hep A is a contagious liver disease. This case appears to be related to travel outside of the state and is not thought to be part of the current hep A outbreak in Northeast Arkansas.

Anyone who ate at this facility from July 19 to August 4 should seek vaccination immediately if they have never been vaccinated against hep A or are unsure of their vaccination status. There are no specific treatments once a person gets hep A. Illness can be prevented even after exposure by getting the vaccine or medicine called immune globulin. This medicine contains antibodies to hep A. The vaccine and medicine work best if given within two weeks of exposure to the virus. However, if it has been more than two weeks since potential exposure but symptoms have not yet developed, the vaccine may still be given.

Anyone experiencing symptoms should seek care immediately. Typical symptoms of hep A include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, or jaundice (yellowing of the skin or eyes). It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months.

Hep A is a contagious liver disease that results from infection with the hep A virus, which is a different virus from the viruses that cause hep B or hep C. It is usually spread when a person ingests tiny amounts of fecal matter from contact with objects, food or drinks contaminated by the feces, or stool, of an infected person.

A person can transmit the virus to others up to two weeks before and one week after symptoms appear. The virus can cause illness anytime from two to seven weeks after exposure. If infected, most people will develop symptoms three to four weeks after exposure. Many people, especially children, may have no symptoms. Almost all people who get hep A recover completely and do not have any lasting liver damage, although they may feel sick for months.

The older a person is when they get hep A, typically the more severe symptoms they have. Other risk factors for having more severe symptoms of hep A include having other infections or chronic diseases like hep B or C, HIV/AIDS or diabetes. Up to one in three adults are typically hospitalized. Death due to hep A is rare but is more likely in patients with other liver diseases (like hep B or C).

Hepatitis A is preventable through vaccination. Hepatitis A vaccine has been recommended for school children for many years and one dose of hep A vaccine is required for entry into kindergarten and first grade as of 2014. Most adults are likely not vaccinated but may have been if they received vaccinations prior to traveling internationally.

As I have said way too often, it seems that hardly a month passes without a warning from a health department somewhere that an infected food handler is the source of yet another potential hepatitis A outbreak. Absent vaccinations of food handlers, combined with an effective and rigorous hand washing policy, there will continue to be more hepatitis A outbreaks. It is time for health departments across the country to require vaccinations of foodservice workers, especially those that serve the very young and the elderly.

The Centers for Disease Control (CDC) estimates that 83,000 cases of hepatitis A occur in the United States every year, and that many of these cases are related to food-borne transmission. In 1999, over 10,000 people were hospitalized due to hepatitis A infections and 83 people died. In 2003, 650 people became sickened, 4 died and nearly 10,000 people got Ig shots after eating at a Pennsylvania restaurant. Not only do customers get sick, but businesses lose customers or some simply go out of business.

Although the CDC has not yet called for mandatory vaccination of foodservice workers, it has repeatedly pointed out that the consumption of worker-contaminated food is a major cause of food-borne illness in the United States.

Marler says hepatitis A continues to be one of the most frequently reported, vaccine-preventable diseases in the United States, despite the FDA-approval of hepatitis A vaccine in 1995. Widespread vaccination of appropriate susceptible populations would substantially lower disease incidence and potentially eliminate indigenous transmission of hepatitis A infections. Vaccinations cost about $50. The major economic reason that these preventative shots have not been used is because of the high turnover rate of foodservice employees. Eating out becomes a whole lot less of a gamble, if all foodservice workers faced the same requirement.

According to the CDC, the costs associated with hepatitis A are substantial. Between 11% and 22% of persons who have hepatitis A are hospitalized. Adults who become ill lose an average of 27 days of work. Health departments incur substantial costs in providing post-exposure prophylaxis to an average of 11 contacts per case.

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 $650 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, who 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.

SEATTLE, Washington – Marler Blog has been selected by the ABA Journal as one of the 100 best digital media for a legal audience. Additionally, Marler Blog along with Food Poison Journal were recognized as two of the Top 30 Food Safety Blogs, Websites & Newsletters to Follow in 2018 by Feedspot.com. Both websites are run by Bill Marler, the managing partner at Marler Clark, the food safety law firm. Mr. Marler uses the sites to raise awareness about foodborne illness outbreaks and recalls and to call for food safety policy reform.

An accomplished attorney and national expert in food safety, William (Bill) Marler has become the most prominent foodborne illness lawyer in America and a major force in food policy in the U.S. and around the world.  Marler Clark, The Food Safety Law Firm, has represented thousands of individuals in claims against food companies whose contaminated products have caused life altering injury and even death.

Bill began litigating foodborne illness cases in 1993, when he represented Brianne Kiner, the most seriously injured survivor of the historic Jack in the Box E. coli O157:H7 outbreak, in her landmark $15.6 million settlement with the company.  The 2011 book, Poisoned: The True Story of the Deadly E. coli Outbreak that Changed the Way Americans Eat, by best-selling author Jeff Benedict, chronicles the Jack in the Box outbreak and the rise of Bill Marler as a food safety attorney.

For the last 25 years, Bill has represented victims of nearly every large foodborne illness outbreak in the United States, filing lawsuits against such companies as Cargill, Chili’s, Chi-Chi’s, Chipotle, ConAgra, Dole, Excel, Golden Corral, KFC, McDonald’s, Odwalla, Peanut Corporation of America, Sheetz, Sizzler, Supervalu, Taco Bell and Wendy’s. Through his work, he has secured over $650,000,000 for victims of E. coli, Salmonella, and other foodborne illnesses.

Among the most notable cases he has litigated, Bill counts those of nineteen-year-old dancer Stephanie Smith, who was sickened by an E. coli-contaminated hamburger that left her brain damaged and paralyzed, and Linda Rivera, a fifty-seven-year-old mother of six from Nevada, who was hospitalized for over 2 years after she was stricken with what her doctor described as “the most severe multi-organ [bowel, kidney, brain, lung, gall bladder, and pancreas] case of E. coli mediated HUS I have seen in my extensive experience.”

Salt Lake County Health Department (SLCoHD) announced today that people who consumed any food item from the Edible Arrangements store at 5211 South State Street in Murray between March 21 and April 13 may have been exposed to hepatitis A. This possible exposure affects only this Edible Arrangements location; health officials estimate that this store sold about 600 arrangements during this time.

Customers who consumed Edible Arrangements items from the Murray store between the dates listed should call 385-468-INFO (4636) for further instructions. The phone line will be staffed from 8:00 a.m. to 5:00 p.m. today through at least Friday, April 20. Health department staff will screen callers for their exposure risk and, if they are eligible, provide them with options for receiving an injection to prevent hepatitis A. To be effective, the injection must be given within 14 days of the possible exposure, so people who ate items from this location between April 4 and April 13 are eligible to receive the injection.

It is too late for people who ate items from this location between March 21 and April 3 to receive the injection, so those individuals should watch for symptoms of hepatitis A and see their health care provider if they’re concerned. Symptoms of hepatitis A include low fever, fatigue, loss of appetite, nausea, vomiting, and yellow skin and eyes.

Customers who are fully vaccinated (two doses) against hepatitis A are protected and do not need to contact the health department or receive vaccine. In July 2002, Utah began requiring hepatitis A vaccination for children entering kindergarten, so many people who began kindergarten during or after the 2002–2003 school year are likely vaccinated against hepatitis A; check your personal immunization record to be sure.

This possible hepatitis A exposure occurred when an employee infected with hepatitis A worked while ill. SLCoHD believes this case is linked to the ongoing outbreak Utah has been experiencing since summer 2017. To date, Salt Lake County has reported 153 hepatitis A cases related to that outbreak. We do not currently have any hepatitis A cases linked to this possible exposure at Edible Arrangements; because the incubation period for hepatitis A is two to seven weeks, we will not know for several weeks if anyone was infected from this possible exposure.

The Utah Department of Agriculture and Food, which permits and regulates this Edible Arrangements location, closed the store yesterday afternoon and will supervise its sanitation before reopening. Under Salt Lake County’s food service regulation, SLCoHD will also require all store employees to be vaccinated against hepatitis A before they return to work.

“Food service establishments should consider vaccinating their employees against hepatitis A,” said Dr. Dagmar Vitek, SLCoHD medical director. “It’s also important that food handlers be conscientious with hygiene, hand washing and not working when ill—and that managers be vigilant in enforcing those important requirements that help protect public health.”

Hepatitis A vaccine is covered by many insurance plans and is available at local pharmacies, health care providers and SLCoHD immunization clinics. People not affected by this possible exposure but who would like to receive the vaccine may call 385-468-SHOT (7468) to make an appointment at a health department immunization clinic.

The Toledo-Lucas County Health Department has confirmed a case of hepatitis A in a food handler at Dave & Buster’s restaurant on Monroe Street, the department said Thursday.

Any restaurant patrons who consumed food or drink there between March 1 and March 29 are encouraged to monitor potential symptoms and contact their health care provider to be assessed for vaccination or treatment.

Hepatitis A is a liver disease that can be spread by ingesting food or water contaminated by feces or through sexual contact. Symptoms such as fatigue, poor appetite, stomach pain, nausea or vomiting, dark urine, and jaundice can appear two to six weeks after exposure.

The employee is not currently working and is receiving medical care, according to the health department. The restaurant, located at 5001 Monroe St., is working with health officials to avoid additional exposure.

Southeast Michigan is experiencing a hepatitis A outbreak that began in August, 2016. As of April 11, 804 cases and 25 deaths have been confirmed in the region, according to the Michigan Department of Health & Human Services. Seventeen of those cases are from Monroe County.

 

Due to an ongoing outbreak of Hepatitis A, the Department for Public Health (DPH) within the Cabinet for Health and Family Services (CHFS), is recommending vaccination for everyone residing in Jefferson, Bullitt, Hardin, Greenup, Carter and Boyd counties.

To date, 214 cases have been reported in the Jefferson County/Louisville area. Bullitt, Hardin, Greenup, Carter and Boyd counties have each reported 5 or more cases for a total 311 cases associated with the outbreak. One death has been reported.

“Hepatitis A is a vaccine-preventable illness. DPH recommends all children, ages 1 year through 18, receive the Hepatitis A vaccine as well as adults who want to protect themselves from an acute hepatitis A infection,” said Dr. Jeffrey Howard, acting DPH commissioner.  “In these counties with local transmission of the hepatitis A virus, we recommend everyone be vaccinated per guidelines to help stop this outbreak.”

For adults, the hepatitis A vaccine is typically given in two doses — an initial vaccination followed by another shot six months later. DPH recommends that all people in outbreak counties consult with their primary care doctor or insurance carrier regarding an in-network provider for administration of the hepatitis A vaccine. The Center for Disease and Control (CDC) recommends vaccination for people who wish to be protected against hepatitis A infection. For insured people, the hepatitis A vaccine should not require any out-of-pocket costs as long as policies are compliant with the federal Affordable Care Act.

Since 2006, the CDC has recommended children receive the hepatitis A vaccine series.  Effective July 1, 2018, all Kentucky students in kindergarten through 12th grade must receive two doses of the Hepatitis A vaccine to attend school or receive a provisional certificate of immunization (unless their parents claim an exemption).

Signs and symptoms of Hepatitis A include jaundice (yellowing of the skin or eyes), dark-colored urine, fatigue, abdominal pain, loss of appetite, nausea, diarrhea and fever. The virus is found in the stool of people infected with Hepatitis A and typically spread from person to person contact. The disease often is transmitted when people do not wash their hands properly or do not have access to proper sanitation.  DPH recommends individuals wash their hands often and particularly after using the restroom or before consuming food. Hand sanitizer should be used only when soap and water is unavailable.

While the current hepatitis A outbreak is occurring primarily within specific at-risk populations, including people who use illicit drugs (both injection and non-injection) and the homeless, through person-to-person transmission.  Approximately, 30 percent of cases do not report any risk factors.  Therefore, it is recommended that children and adults in counties with local transmission of the virus as part of this outbreak receive the hepatitis A vaccine.

Hepatitis A vaccine is widely available at local pharmacies and health care providers. For additional information on the hepatitis A vaccination, please visit https://www.cdc.gov/hepatitis/hav/afaq.htm#E1.

The Ashland-Boyd County Health Department reported on Tuesday that customers of both Waffle House restaurant locations in Boyd County were potentially exposed to the highly contagious virus by an infected foodservice worker.

“The single employee worked at each location during the infectious period,” according to the public health alert. “The window of possible exposure was Feb. 12-28.

The Waffle House restaurant owner and employees have cooperated fully with the local and state health officials to identify all employee contacts, according to the county alert. Waffle House employees are receiving post-exposure vaccinations.

Anyone who consumed foods or beverages at either of the Waffle House locations during the possible exposure period is urged to monitor themselves for signs of infection in the coming weeks. It can take up to 50 days after exposure for symptoms to develop, according to the U.S. Centers for Disease Control and Prevention.

Some of the Waffle House customers still have time to receive post-exposure vaccinations. The after-the-fact injections must be giving within 14 days of exposure or they are not effective. The last date for the post-exposure vaccine is March 13, according to the county health department.

Hepatitis A is a liver disease caused by a virus. Symptoms, when present, can include fatigue, low appetite, stomach pain, nausea, and the yellowing of the eyes or skin. Some adults and most young children do not develop symptoms while infected, but they can spread the virus. The virus can contaminate foods, beverages, surfaces, clothing, bed linens — often because of inadequate handwashing. Hepatitis A can also be spread by close personal contact with an infected person, including sexual contact and sharing needles.

In Kentucky, 148 cases have been confirmed through laboratory testing since Jan. 1, 2017. The state health department officially declared the outbreak on Nov. 28, 2017. Multiple Kentucky counties have reported confirmed outbreak cases, but Louisville in Jefferson County has the vast majority at 124 as of Tuesday. Of the state’s confirmed cases, 107 of the people have had such severe symptoms that they required hospitalization. The person who died was a Jefferson County resident.

The outbreak strain was first identified in California, but cases have been confirmed in several states, including Michigan, Utah, Oregon and Nevada. Nationwide more than 1,200 people have been confirmed in the outbreak, with the majority requiring hospitalization. More than 40 deaths have been confirmed.

According to the Arkansas Department of Health, officials are warning of a possible Hepatitis A exposure after a Taco Bell employee in Corning tested positive for the virus.

In a statement, officials asked that anyone who has eaten food at the restaurant between Jan. 24 and Feb. 7, 2018 and is having symptoms should call their doctor immediately.

Also, officials said they believe there is no known risk for anyone who ate at the restaurant after Feb. 7 at this time.

There are no specific treatments available once a person gets the virus, officials say.

However, the virus can be prevented by vaccination or through getting immune globulin medicine.

The medicine, officials say, includes antibodies from people who are immune to the virus and is effective if a person receives it within two weeks of exposure. If a person at the restaurant on Feb. 1, they would need to get medical help by Feb. 15.

The symptoms of Hepatitis A are fever, loss of appetite, fatigue, nausea, vomiting, abdominal pain, dark urine, joint pain, clay-colored bowel movements or jaundiced skin.

The virus, which can cause people to be sick within two to seven weeks of exposure, can also be transmitted to other people up to two weeks before and a week after the symptoms happen, officials say.

The Clay County Health Unit in Piggott will have immune globulin and Hepatitis A vaccine medicine available for people, upon request with an appointment or after Feb. 15.

People can call 870-598-3390 for more information on getting the medicine.