Scallops suspected of triggering a major hepatitis A outbreak in Hawaii came from the Philippines and were served at Genki Sushi restaurants on Oahu and Kauai but not other islands, state health officials said Tuesday.
The state slapped an embargo on the suspect scallops and their distributors and shut down Genki Sushi’s 10 restaurants on Oahu and single outlet on Kauai late Monday. Health Director Dr. Virginia Pressler said the department acted immediately after concluding the scallops were the likely source of the outbreak, the worst in the state in two decades.
The hepatitis A virus, a contagious liver disease, has sickened at least 168 people at last count, including 46 who had to be hospitalized. More cases are expected because the disease has a long incubation period. It typically spreads through contaminated food.
The imported frozen scallops, chopped and served raw with mayonnaise atop a rice ball wrapped with dried seaweed, were among sushi items offered on conveyor belts to customers. The Health Department identified the product as Sea Port Bay Scallops (Wild Harvest, Raw Frozen), with the notation “Product of the Philippines.”
State Epidemiologist Dr. Sarah Park advised anyone who has eaten at Genki Sushi on Oahu or Kauai recently, especially if they had scallops, to contact their health care provider about getting the hepatitis A vaccine or immune globulin, which can prevent the disease if given within two weeks of exposure. She also told them to watch for symptoms of the disease for up to 50 days.
Dane Nakamura, chief operating officer of Koha Oriental Foods, said his company distributed the scallops only to Genki Sushi on Oahu and Kauai. The company no longer has any of the product, he said. Federal investigators tested the scallops last week, but he hasn’t received results.
“We understand what the Health Department is doing in trying to get ahead of this,” Nakamura said. “We haven’t got anything back from the FDA. It’s not a product recall because it’s not a positive identification.”
The Health Department successfully blocked the shipment of the scallops from another distributor, True World Food on Oahu, so none of the product went to Genki Sushi restaurants on Maui or Hawaii island. All of those scallops are being destroyed.
A team from the Centers for Disease Control and Prevention arrived Aug. 7 to help with the investigation. Asked whether federal assistance would have helped solve the mystery sooner, Park said the extra expertise arrived just in time.
“Had the CDC team been here earlier, then perhaps we would have made this association sooner, but I actually don’t think so,” Park said. “I think we were headed that way, and the point the CDC team came was actually the critical point … where there were just too many tasks to assign and not enough staff to complete them.”
She credited the public with helping identify the source. A survey posted online by the Health Department last week found that local residents were far less likely to have dined at Genki Sushi than those who contracted hepatitis A.
“I can’t thank the public enough for their exuberant response,” Park said Tuesday. “I think we received over 5,300 responses. It was just amazing. I think it speaks to our community wanting to come together and protect our public’s health.”
The Health Department found that 70 percent of the hepatitis A victims it interviewed had eaten at Genki Sushi in the past seven weeks, while the online survey of the general public found 23 percent of respondents had eaten there.
“With no other restaurant or food chain or grocery store have we found such an association,” Park said.
The news came as a surprise to Genki Sushi officials. None of the chain’s employees has contracted the disease, said Mary Hansen, chief administrative officer of Genki Sushi USA Inc.
“Genki Sushi was shocked when we received the order to immediately close our restaurants on Oahu and Kauai,” Hansen said, but it complied right away. “Genki Sushi cares about the public and our customers’ health and safety. We will continue to work with the Department of Health to ensure that we are in compliance so that we can open our restaurants as soon as possible.”
Those restaurants are being sanitized from top to bottom, all food supplies are being destroyed and single-use items such as napkins and cups are being thrown away under oversight of the Health Department, according to Peter Oshiro, Sanitation Branch chief.
“Genki Sushi in Hawaii has a history of good compliance with food safety regulations, which includes good employee hygiene,” Oshiro said.
“We have been working closely with Genki throughout this investigation,” he said, adding that the company readily shared invoices, distribution records and other documents. “They have been a very good partner. We thank them for helping us crack this case.”
Hepatitis A is spread through contaminated food or drink, or by close personal contact with a carrier. Its symptoms, which can appear weeks after exposure, include fatigue, nausea, abdominal pain, dark urine, joint pain and jaundice — a yellowing of the skin and eyes.
Only a few of the 168 victims contracted the disease from another person, Park said. All the victims so far are adults. The first began showing symptoms June 12, and could have been exposed as far back as mid-April, and the most recent onset of illness was Aug. 1.
The vast majority of cases have been on Oahu. Eight of the victims lived on the neighbor islands, and one visitor has returned to the mainland.
One person who contracted hepatitis A was already terminally ill and in hospice care, and later died. It isn’t clear whether the death was due to hepatitis or the underlying health problem, but it is likely the latter, said Jonathan Hilts, a public health educator.
Investigators are still trying to figure out how individuals who fell ill but don’t recall eating at Genki Sushi may have contracted the disease. The department previously identified several other restaurants, each with a single employee who had hepatitis A, but so far none of them passed it on.
“At this time we have not identified any cases related to those food workers, which is good news,” Park said. “But it doesn’t mean we are completely out of the woods, because hepatitis A has an incredibly long incubation period.”
“We are at a milestone here,” she added. “This is not the finish line.”
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>> For more information on the outbreak and how to prevent its spread, visit health.hawaii.gov.