High priority groups for getting the hep A vaccine include:

  • Anyone who has had close contact with someone who has hep A
  • Food workers
  • People who use drugs, whether injected or not
  • People experiencing homelessness, transient, or unstable housing
  • People who have been recently incarcerated

See also, Hepatitis A cases in the U.S. have tripled this year, as our nation’s public health infrastructure continues to rot. https://www.huffingtonpost.com/entry/hepatitis-a-outbreak-america_us_5c0ecf0fe4b06484c9fd9d0c?ncid=engmodushpmg00000004

Tennessee

Metro Public Health Department officials confirmed today that an employee working at the Outback Steakhouse Restaurant Rivergate, located at 1560 Gallatin Pike N, Madison 37115, has been diagnosed with acute hepatitis A.  The restaurant employee worked at the restaurant while symptomatic December 22-24, 2018.

The Metro Public Health Department will open a special clinic to offer free Hepatitis A vaccine at the Lentz Public Health Center (2500 Charlotte Ave.) on the following dates and times to those who dined at that location on December 22nd-24th.  The potential exposure occurred only at Outback Steakhouse Restaurant’s Rivergate location.  Individuals who dined at the restaurant on those dates have until January 7th to be vaccinated.

Hepatitis A Vaccination Clinic
Lentz Public Health Center
2500 Charlotte Avenue
Nashville, Tennessee

  • January 3rd:  8:00 a.m. – 4:30 p.m.
  • January 4th:  8:00 a.m. – 4:30 p.m.
  • January 5th:  10:00 a.m. – 2:00 p.m.
  • January 7th:  8:00 a.m. – 4:30 p.m.

Symptoms of hepatitis A are fatigue, decreased appetite, stomach pain, nausea, darkened urine, pale stools and jaundice (yellowing of the skin and eyes). People can become ill 15 to 50 days after being exposed to the virus. Anyone experiencing symptoms should seek medical attention.

Metro Public Health Department officials have confirmed 161 cases of hepatitis A have been reported in Nashville since December 2017.

The Health Department continues to lead a hepatitis A vaccine campaign, along with community partners and the Tennessee Department of Health.  The Health Department and our community partners have vaccinated nearly 9,000 people in Nashville since the outbreak was announced in late May. The total vaccinated does not include vaccine given by private providers.

Arkansas

Northeast Arkansas continues to have a hepatitis A (hep A) outbreak, and the ADH is warning of a possible hep A exposure after an employee of On the Border Mexican Grill & Cantina in Jonesboro tested positive for the virus.

Anyone who ate at the On the Border restaurant at 2324 Red Wolf Blvd, Jonesboro, AR 72401 between Dec. 13 to Dec. 27 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. Hep A vaccination can still prevent the virus after exposure.

The ADH will host two vaccine clinics, the first on Jan. 4 from 8 a.m. to 5 p.m. at the Craighead County Health Unit at 611 E Washington Ave, Jonesboro, AR 72401, and the second on Jan. 5 from 9 a.m. to 2 p.m., also at the Craighead County Health Unit. The vaccine will be provided to the public at no cost. People should bring their insurance card and driver’s license if they have one. Those who are unable to attend the clinics listed above because they are in another county but ate at the restaurant during the time period may be able to visit a Local Health Unit in their counties. Those visiting Local Health Units in other counties should call ahead to ensure vaccine is available. Local Health Unit listing can be found at https://www.healthy.arkansas.gov/health-units.

Since February, 237 cases of hep A have been reported as part of an outbreak in Northeast Arkansas, including two deaths. Greene, Craighead, and Clay counties have had the most cases, although there have been cases in Arkansas, Cleburne, Cross, Independence, Jackson, Lawrence, Lee, Logan, Mississippi, Monroe, Phillips, Poinsett, Randolph, Sharp and White counties.

As I have said before:

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 food-service workers, especially those who serve the very young and the elderly.

Hepatitis A is a communicable disease that spreads from person-to-person. It is spread almost exclusively through fecal-oral contact, generally from person-to-person, or via contaminated food or water. Hepatitis A is the only foodborne illness that is vaccine-preventable. According to the U.S. Centers for Disease Control and Prevention (CDC), since the inception of the vaccine, rates of infection have declined 92 percent.

CDC estimate 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, more than 10,000 people were hospitalized due to hepatitis A infections, and 83 people died. In 2003, 650 people became sickened, four died, and nearly 10,000 people got IG (immunoglobulin) shots after eating at a Pennsylvania restaurant. Not only do customers get sick, but also businesses lose customers or some simply go out of business.

Although CDC has not yet called for mandatory vaccination of food-service workers, it has repeatedly pointed out that the consumption of worker-contaminated food is a major cause of foodborne illness in the U.S.

Hepatitis A continues to be one of the most frequently reported, vaccine-preventable diseases in the U.S., despite 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 preventive shots have not been used is because of the high turnover rate of food-service employees. Eating out becomes a whole lot less of a gamble if all food-service workers faced the same requirement.

According to CDC, the costs associated with hepatitis A are substantial. Between 11 percent and 22 percent 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. Average costs (direct and indirect) of hepatitis A range from $1,817 to $2,459 per case for adults and from $433 to $1,492 per case for children younger than 18. In 1989, the estimated annual direct and indirect costs of hepatitis A in the U.S. were more than $200 million, equivalent to more than $300 million in 1997 dollars.  A new CDC report shows that, in 2010, slightly more than 10 percent of people between the ages of 19 and 49 got a hepatitis A shot.

Vaccinating an employee make sense.  It is moral to protect customers from an illness that can cause serious illness and death. Vaccines also protect the business from the multi-million-dollar fallout that can come if people become ill or if thousands are forced to stand in line to be vaccinated to prevent a more serious problem.