A Hawaiian Airlines flight attendant has come down with hepatitis A, prompting warnings to passengers who were on the same flights in July to consider getting screened or vaccinated against the contagious liver disease.

The flight attendant and an employee of a Chili’s restaurant in Kapolei were identified Tuesday by the state Department of Health as the newest victims of the virus. The outbreak, the largest in nearly two decades, has affected nearly 100 people in the islands since the first person fell ill June 12.

The Health Department said the risk of transmission during the airplane flights or while dining at Chili’s is very low and that there is no evidence any customers contracted the disease. Still, it recommends that patrons contact their health care providers about possible vaccination.

“This is an isolated incident,” Hawaiian Airlines spokeswoman Alison Croyle said Tuesday, referring to the crew member who tested positive. “As the Department of Health has stated, no infections have been linked to exposure at Hawaiian, and we are not a source of the outbreak.

“While there is a small risk of exposure to communicable diseases in any public environment, as an airline Hawaiian maintains very high standards of hygiene and cleanliness to safeguard the health of crew and guests,” she said. “However, we are taking this very seriously and are taking the necessary precautions.”

The airline is advising passengers on any of the 33 flights the crew member worked on between July 1 and 26 to contact their health care providers regarding possible screening. If a passenger in consultation with a doctor determines that screening or vaccination is needed, Hawaiian will reimburse the out-of-pocket expense.

On Tuesday state epidemiologist Dr. Sarah Park suggested that the broader public also consult with their medical providers about hepatitis A vaccination, which provides long-lasting protection. It can also prevent infection after exposure to the virus if administered within two weeks.

“Considering getting vaccinated is a good thing for everyone to think about, to talk about with their health care providers,” Park said. “The other is thorough hand-washing, especially before handling food.”

The hepatitis A virus is shed in the stool of an infected person long before any symptoms are shown. It is transmitted through food or drink that is contaminated with traces of stool. The disease also spreads easily within households.

The flight attendant flew on 28 interisland flights, plus three flights to Oakland, Calif., one to Las Vegas and one to Sydney between July 1 and 26. Details are available at hawaiianairlines.com/hepatitisA.

All crew members who worked those flights will be screened before returning to duty, Croyle said.

The employee at Chili’s, which is at 590 Farrington Highway, was at work on July 10, 12, 14-15, 17-18, 20-23 and 25-27.

As of July 26, 93 people had come down with hepatitis A in this outbreak. The Health Department confirmed that the two new cases are not included in that figure, and said it would provide a new total today.

“We are frustrated but we are not surprised to see more cases,” Park said. “It corroborates what we suspect about the product (that may be causing it). It’s widely distributed, commonly consumed.

“As much as we are seeing more cases, I think I can safely say that we are seeing progress in the investigation,” she said. “I can’t say anything definitive. At least we have a few good leads, we think, to start following up on.”

Hepatitis A is hard to stop because of its long and quiet incubation period, which can last up to 50 days. Most people tend to get sick at least a month after they were exposed to the virus, Park said.

Food service workers at three other establishments have also been identified with hepatitis A, but their workplaces were found not to be sources of the disease.

Symptoms of hepatitis A include fever, fatigue, loss of appetite, abdominal pain, dark urine, diarrhea and yellow skin and eyes. Anyone who falls ill should stay at home and contact a doctor.

For more information visit health.hawaii.gov/docd/hepatitis-a-outbreak-2016.