Vaccinations key to healthy public

One year ago last week, on June 12, 2016, the first victims of a hepatitis A outbreak in Hawaii began to show symptoms of the infectious liver disease. Roughly two months later, the state Department of Health (DOH), aided by the U.S. Centers for Disease Control, tracked down the likely source: raw scallops imported from the Philippines and served at Genki Sushi.

Samples of the scallops tested positive for hep A. Notifications were issued and vaccination programs launched. But the damage was done. By the end of September, 284 cases were confirmed and the number would keep climbing, making it the worst hep A outbreak in Hawaii in two decades. More than 70 people were hospitalized.

Fast-forward to May 2 of this year, when DOH reported that hepatitis A was discovered in raw ahi imported from Indonesia and distributed by Tropic Fish Hawaii, LLC.

This time, the source was identified within days of distribution, the product quickly recalled, and government officials and the public notified without undue delay. So far, there have been no signs of another serious outbreak.

Are there lessons to be learned here? Certainly.

Tropic Fish kept careful records, regularly tests its products, and did not hesitate to publicize and correct its error once it was discovered. The company’s actions likely helped avert another major outbreak.

The U.S. Food and Drug Administration, which regulates seafood imports, publishes safe-handling guidelines that local companies should follow. But given Hawaii’s outsized appetite for raw seafood, kept affordable by a dependence on foreign-sourced products, going beyond what’s required makes good business sense.

That includes regular and rigorous testing of raw seafood imported from overseas, before the product is distributed to restaurants, stores and other retail customers. Perhaps such testing would have caught the tainted scallops before they reached the restaurants. In any event, solid safety protocols should be a norm that customers expect.

There was another lesson, too: the importance of vaccinations. During the 2016 hep A outbreak, tens of thousands of people were vaccinated for the disease. Seattle attorney Bill Marler estimated that nearly 100,000 people received shots between July and October, based on records from Hawaii’s largest insurance companies.

So the public was already well-informed about hep A vaccinations when the tainted ahi was discovered in May. Medical clinics were well-stocked with vaccines. Enhanced public awareness and a willingness to get the necessary shots likely contributed to keeping this health problem under control.

“Hawaii is probably the most vaccinated population in America now,” Marler said.

Now the state is facing another outbreak — this time it’s the mumps. As of Thursday, the number reached 104, the largest outbreak in Hawaii in decades.

The mumps shares some similarities with hep A. It’s a contagious viral disease; its effects are generally mild, but complications can be serious; it has a long incubation period; many people don’t know if they’ve been vaccinated; and two shots are more effective than one.

Unlike hep A, however, mumps isn’t particularly attention-grabbing. Even so, it is not to be trifled with. It’s highly contagious, spread through respiratory secretions, such as those that occur with sneezing or coughing. On rare occasions, the mumps can lead to meningitis, deafness, or swelling of the brain, testicle or ovaries.

So follow DOH’s recommendation: two doses of the measles, mumps and rubella vaccine (MMR) for children, as well as adults who can’t document having received their MMR shots.

These recent incidents have raised public awareness about how diseases can spread in Hawaii’s communities. The next step is for the public to be proactive — get our shots, pay attention to health alerts, and do our part to keep a small disease outbreak from turning into a large one.