Hepatitis A case verified on Hawaii Island at Waikoloa restaurant

MEDIA RELEASE FROM DOH

HONOLULU – The Hawaii State Department of Health (DOH) has confirmed a new case of hepatitis A infection in a food service employee on Hawaii Island. The employee has a history of exposure on Oahu and worked at the fast food and catering restaurant, Sushi Shiono Waikoloa, located in the Waikoloa Beach Resort, Queen’s MarketPlace at 69-201 Waikoloa Beach Drive, from July 5 through July 21, 2016 (actual dates: July 5-8, 11-15, and 18-21).

The department is advising persons who consumed any food products from this store during this period that they may have been exposed to the disease. The likelihood that patrons of this business will become infected is very low. However, as a precaution, unvaccinated individuals should contact their healthcare providers about the possibility of receiving hepatitis A vaccine or immune globulin, which may provide some protection against the disease if administered within the first two weeks after exposure.

Since the outbreak began in mid-June, there have been 93 confirmed cases of hepatitis A, 29 of which have required hospitalization. All cases have been in adults who were on Oahu during their exposure periods. DOH continues to investigate and is working to identify the source of infection for this outbreak.

“Preventing exposure from infected food handlers is difficult because patients with hepatitis A are most contagious one to two weeks before symptoms start,” said State Epidemiologist Dr. Sarah Park. “It is possible that other food service establishments will be affected with additional new cases.”

Affected food service establishments who are unable to notify their customers directly are listed on the DOH website at health.hawaii.gov/docd/hepatit…. These businesses are not sources of this outbreak. At this time, no infections have been linked to exposure at these businesses; the list is provided to prevent possible new cases.

Hawaii State law requires all unvaccinated food handlers (persons who directly prepare, serve, or handle food) who are contacts of confirmed cases be tested for infection and have a negative hepatitis A IgM test before returning to work. A “contact” with the case is defined as unvaccinated household members, unvaccinated sexual contacts, anyone sharing illicit drugs with a case, anyone sharing food or eating or drinking utensils with a case, anyone consuming ready-to-eat foods prepared by an infectious food handler with diarrhea or poor hygiene. Once an infected food handler has been identified, DOH staff coordinate directly with the owners and managers of the affected food service establishments to ensure their employees are tested before resuming their work.

Symptoms of hepatitis A infection include fever, fatigue, loss of appetite, abdominal discomfort, dark urine, diarrhea, and yellow skin and eyes. Individuals, including food service employees, exhibiting symptoms of hepatitis A should stay home and contact their healthcare provider.

While vaccination provides the best protection, frequent and thorough handwashing with soap and warm water after using the bathroom, changing a diaper, and before preparing food can help prevent the spread of hepatitis A. Appropriately cooking foods can also help prevent infection.

Additional information about hepatitis A can be found on the DOH website at

health.hawaii.gov/docd/hepatit….

For a statewide list of vaccinating pharmacies, visit

health.hawaii.gov/docd/files/2… or call the Aloha

United Way information and referral line at 2-1-1


The Hawaii Department of Health (HDOH) is investigating a cluster of hepatitis A infections on Oahu. HDOH staff are conducting interviews with the cases in an effort to identify the source of infection.

Identifying the source of infection continues to be a challenge because of the long incubation period of the disease and the difficulty patients have in accurately recalling the foods consumed and locations visited during the period when infection could have taken place.

Healthcare providers have been informed and are asked to notify HDOH immediately if they have a patient they suspect may be infected.

Individuals who are interested in being vaccinated should contact their healthcare providers.

CONTACTS OF CASES

Unvaccinated contacts of cases should talk to their healthcare providers about the possibility of receiving hepatitis A vaccine or immune globulin, which may provide some protection against the disease if administered within the first two weeks after exposure.

A contact is defined as:

Note: A food handler is any person who directly prepares, serves, or handles food.

Unvaccinated food handlers who are contacts of cases must have a negative hepatitis A IgM test before they return to work.

Places of Interest

An employee of the following food service business(es) has been diagnosed with hepatitis A. This list does not indicate these businesses are sources of this outbreak; at this time, no infections have been linked to exposure to these businesses. The likelihood that patrons of these businesses will become infected is very low. However, persons who have consumed food or drink products from these businesses during the identified dates of service should contact their healthcare provider for advice and possible preventive care.

Hepatitis A Places of Interest in Hawaii

EstablishmentIslandLocationDates of Service
Baskin-RobbinsOahuWaikele CenterJune 17, 18, 19, 21, 22, 25, 27, 30, and July 1 and 3, 2016
Chili’sOahuKapolei (590 Farrington Highway)July 10, 12, 14, 15, 17, 18, 20, 21, 22, 23, 25, 26, and 27, 2016
Costco BakeryOahuHawaii KaiJune 16-20, 2016
Hawaiian AirlinesFlight list (click here)July 1-26, 2016
Sushi ShionoHawaiiWaikoloa Beach Resort, Queen’s MarketPlace (69-201 Waikoloa Beach Drive)July 5-8, 11-15, and 18-21, 2016
Taco BellOahuWaipio (94-790 Ukee Street)June 16, 17, 20, 21, 24, 25, 28, 29, 30, and July 1, 3, 4, 6, 7, and 11, 2016
As of July 26, 2016*:

Since the last update, HDOH has identified 19 new cases of hepatitis A. All cases have been in adults, 29 have required hospitalization.



All of the cases were on Oahu during their exposure period. Four individuals now live on the islands of Hawaii, Kauai, and Maui.
CONFIRMED CASES OF HEPATITIS A: 93
Onset of illness has ranged between 6/12/16 – 7/19/16.

Information for clinicians: For updates, go to health.hawaii.gov/docd/updates…

HEPATITIS A — INFORMATION AND RESOURCES