The Health Department is trying a new tool in its investigation of the hepatitis A outbreak, asking local residents to fill out an online survey to show where they have bought groceries or eaten out recently.
The department posted the short “Restaurant and Grocery Store Survey” on its website Wednesday and expects to keep it open through today. Comparing survey results from people in specific ZIP codes with those who contracted hepatitis A could help narrow the search for the contaminated food or drink causing the outbreak.
“We are trying to get a really rough snapshot of the background of our population in terms of the places that they might frequent,” said Dr. Sarah Park, state epidemiologist. “We have been amassing a lot of data from our cases, and some things look really compelling. But we don’t want to make assumptions.”
“Nobody has any kind of reference data to let us know that this proportion of the population tends to frequent this establishment, this proportion tends to frequent that establishment or go grocery shopping here or there. If we can know that and compare it to the case data, hopefully that will help a ton in terms of trying to distinguish the weeds, or the signals from the weeds.”
So far, 168 people have been infected, mostly on Oahu, in the worst hepatitis A outbreak in more than two decades in Hawaii. The virus is spread usually through food or drink contaminated with traces of the feces of an infected person. The infectious liver disease can also spread through close personal contact.
Investigators believe the likely source of the outbreak is a food or drink product brought to Oahu and widely distributed here. That’s because hepatitis A rarely occurs in Hawaii since the state has good hygiene and ready access to clean drinking water, Park said. Still, locally produced food items have not been ruled out.
“We suspect this is probably low-level contamination,” she said. “If it were higher, you’d expect a lot more people.”
The Health Department public survey lists 44 fast-food outlets, restaurants and grocery stores, and asks respondents to indicate where they have shopped or dined in the past seven weeks. Participants are also asked for their age and ZIP code. Only one resident per household is asked to fill it out.
So far 46 of the 168 people who have come down with hepatitis A have required hospitalization. All the cases identified in the current outbreak are in adults. Most children in Hawaii have been vaccinated against the disease.
Among those who were hospitalized is a noninstructional, technical-support employee at Kamehameha Schools Kapalama who was diagnosed with hepatitis A on Sunday.
The worker, whose health is improving, has had no contact with students in the past six weeks and had no food handling or transportation duties, according to the school’s medical director, Dr. Kenneth Fink. He sent a message to Kapalama parents Tuesday to fill them in on the situation. School started this week.
Hepatitis A can be transmitted weeks before an individual shows symptoms. Symptoms include loss of appetite, fatigue, dark urine, fever, abdominal pain, diarrhea and yellow skin and eyes. Anyone who falls ill should stay at home and contact their doctor.
The Health Department says vaccination against the disease is the best prevention, and everyone is encouraged to consult with their health care providers about getting the vaccine. A list of pharmacies that offer it is on the department’s website at health.hawaii.gov.
Kaiser Permanente announced Thursday that its members can get vaccinated at no charge by calling for a same-day appointment at any Kaiser medical facility.
Kaiser members who are adults can get vaccinated as a “walk-in” without an appointment at the Honolulu and Waipio clinics from 9 a.m. to noon and 1 to 4 p.m. Mondays through Fridays, and from 8 a.m. to noon Saturdays. Walk-ins are also accepted at its Moanalua Medical Center from 4:30 to 8:30 p.m. daily after check-in at the Volunteer Desk in the lobby.
Kaiser members with children needing vaccination should call their doctor.
The Centers for Disease Control and Prevention recommends that children be vaccinated against hepatitis A starting at age 1. CDC data show that 87 percent of young children in Hawaii receive the first dose of the vaccine but just 55 percent get the second dose before age 3 as recommended.
The vaccination, administered in two doses at least six months apart, provides long-lasting protection.
Vigorous hand-washing with soap and warm water after using the toilet and before eating or preparing food can prevent the spread of the virus. Hepatitis A can cause a mild illness lasting a few weeks, but severe cases can go on for months and cause serious liver damage.
To take the online survey or learn more about hepatitis A, visit 808ne.ws/2asZqbo.
