One part of the recent hepatitis A outbreak has nearly ended — the shortage of available vaccine.
“There was a spike in people wanting to do the vaccination, so we’ve been doing many more than normal,” said Michele Yonemori, pharmacist at Shiigi Drug Company in Hilo. “At first there was a shortage.”
Those kind of effects from the outbreak have taught health officials valuable lessons.
“This outbreak was the result of a contaminated food product,” State Epidemiologist Dr. Sarah Park said in an interview Thursday.
Restaurants are where most people became infected, from eating raw scallops. But Park said it turned out scallops inside vacuum-sealed packages were likely contaminated with hepatitis A before they arrived here.
The Hawaii Department of Health said in mid-August that the scallops, from the Philippines, supplied to Genki Sushi restaurants on Oahu and Kauai were probably the source of the ongoing outbreak.
Vaccine providers in general ran low of vaccine because they hadn’t expected the outbreak and surge in vaccine interest, said Yonemori. But supplies have been beefed up, and there’s plenty available locally to meet demand now.
However, “We’re still hearing that there’s increased interest in vaccination,” Park said.
As of Wednesday, the Department of Health has confirmed 252 cases of hepatitis A linked with the current outbreak, all adults, and 66 of those people required hospitalization.
Registered nurse Chad Shibuya, director of infection prevention at Hilo Medical Center, put that number in context, noting that about 2,500 people get sick with hepatitis A in a given year nationwide.
“We’ve had to learn a lot about hepatitis, also, in this process,” he said.
For example, he said, children typically have been the ones who get vaccinated, which might be the reason, so far, that only adults have been affected during the current outbreak.
Park added that no vaccinated members of the military, or vaccinated children of military personnel, have been diagnosed with hepatitis A. However, she noted, unvaccinated military spouses have indeed been diagnosed.
“I think it really speaks volumes to the effectiveness of the vaccine,” she said.
Hilo restaurants, workers and diners, so far, have been spared. But one restaurant on Hawaii Island, Sushi Shiono in Waikoloa, was impacted in July when a worker tested positive from an infection that likely happened on Oahu. All other employees at the restaurant tested negative and returned to work. A Hawaiian Airlines flight attendant also was diagnosed.
Those taken ill have experienced onset of symptoms between June 12 and Aug. 30, with onset starting up to 50 days after exposure. As the 50 days pass for each restaurant, with no new cases, the establishment is dropped from the Department of Health’s updated list of affected locations, Park said. Sushi Shiono is close to that 50 days. The state announced Friday that Genki Sushi restaurants have been approved to reopen.
Hepatitis A symptoms can include fever, fatigue, loss of appetite, abdominal discomfort, dark urine, diarrhea, yellow skin and eyes, pale-colored stools, vomiting, and headaches and/or body aches.
Vaccination offers the best protection, the Department of Health says, and Park recommends that individuals and families consider getting vaccinated.
She said there’s always a risk whenever you eat something raw.
“I certainly enjoy a good sashimi, too, like everybody,” she said. But, “you’ve got to keep in mind, there is that risk.”
Hawaii residents are fond of raw fish, Park said. But “that means we end up being a bit of a canary-in-a-coal-mine for the rest of the country.”
In other parts of the country, illnesses from raw fish are rare enough that they’re hard to pick up via surveillance, whereas, in Hawaii, it’s easier to trace such an outbreak because so many people eat sushi.
Park said some restaurants have expressed interest in offering vaccinations to all staff members who are interested. But customers who ate the tainted scallops during the current outbreak would still have gotten sick.
To help prevent spread of the hepatitis A virus, state health officials recommend scrubbing hands thoroughly with soap and warm water after using the bathroom, after changing a diaper and before preparing food.
People wishing to get vaccinated can check with their health provider or pharmacy. Yonemori said it’s possible to get a vaccination without a prescription. But pharmacies won’t be able to submit an insurance claim without one.
For the latest information, go to http://health.hawaii.gov/docd/hepatitis-a-outbreak-2016/.
