The state’s Department of Health is investigating at least 10 medical cases in Hawaii during a four-month period that started in May in which individuals suffered acute liver inflammation and failure.

The only common finding among all the Hepatitis cases, at this point, is the use of a dietary or nutritional supplement for the purpose of weight loss and/or muscle gain in the past six months. Cases have been reported from every county in the state. So far, the cases involve patients with no tie to infectious causes, no history of engaging in high-risk social activities, and no identified commonly expected risk factors for liver failure. 

 In a news release issued by the Department of Health, state epidemiologist Sarah Park said, “We are still in the early stages of this investigation and we have not identified the exact source of this condition.”  She added, “However, we want to alert the public because of our concern that more people could potentially become ill.” 

The department urges all persons who use dietary or nutritional supplements for weight loss and/or muscle gain to do so with caution and under their health care providers’ guidance and monitoring. Persons who develop symptoms, such as abdominal pain or discomfort, fatigue, loss of appetite, nausea and/or vomiting, and yellow skin or eyes, should consult their health care provider immediately.

DOH has issued a statewide Medical Advisory to clinicians, clinics, and emergency departments to facilitate identifying more possible cases. DOH is collaborating closely with the U.S. Centers for Disease Control and Prevention as well as the U.S. Food and Drug Administration, as the investigation may involve a federally regulated supplement with national distribution.