Transparency? Hepatitis A outbreaks in Belize, UK schools

The Ministry of Health is working to contain a localized outbreak of Hepatitis A at a government school in Buena Vista, Cayo.

hepatitis.AAccording to reports, there was one case of the virus reported before Christmas, and since then at least 20 more cases

The outbreak in a public school has been kept under the radar by the Ministry of Health. When the media asked Ministry of Health C.E.O. Peter Allen about it, he was surprised by the fact that the news had gotten out. But, of course, he claims that the Ministry seems to have the situation under control.

“I don’t know why I am surprised that the media knows more about these things than I ever expect them to but indeed, we appear to have an outbreak of Hepatitis A in that particular school.”

The UK is a tad more forthcoming, noting that vaccinations are being offered to staff and children at a school in Portsmouth after a case of Hepatitis A was discovered.

A pupil at Isambard Brunel Junior School contracted the illness, which is often associated with foreign travel.

Public Health England (PHE) has recommended vaccinations for those who have been in close contact with the child, including a class at the school.

And so it goes: Marj’s closes following hepatitis A exposure event

When a restaurant’s food safety practices are called into question isn’t usually good business. The restaurant industry isn’t the most stable at the best of times.

Anecdotally, vocal and passionate community members support a local diner or meeting place, even after illnesses; but sales still often plummet.

In 2010, salmonellosis hit 60+ patrons of a Durham, NC BBQ joint, Bullocks. Sam Poley, marketing director for the Durham Convention & Visitors Bureau said, “This is a long-standing restaurant … 58 years in business … never had anything less than an ‘A’ health rating.” Sales dropped 80% and the usually busy restaurant was close to empty.logo

Three days after being linked to a hepatitis A exposure (where an ill cook was diagnosed with the virus, Marj’s, the Alma, Ontario institution closed it’s doors. According to CTV, owner Keith McLean released the following statement:

There are several factors for Marj’s Village Kitchen Inc. closing, economic times, the remote location for winter traffic, the restaurant has been struggling financially and now the reputation has been tainted.

There has been a serious cash flow problem resulting from this last incident. It is important that staff and patrons seek medical attention, even though the chances are next to nil of contracting this condition from Marj’s.

There has been an outpouring of concern about Marj’s. Management would thank those individuals for their past patronage plus their well wishes. Thank you sincerely.



Seen and heard: Hepatitis A exposure in Ontario

Line-ups usually seen at the Fergus curling club or Legion bar – not at the offices of Wellington-Dufferin-Guelph Public Health (below, exactly as shown). Following the report of a hepatitis A-positive cook at Marj’s, an Alma, Ontario (that’s in Canada) diner, public health officials have been busy issuing protective IgG shots to exposed patrons.

According to The Record, at least 600 shots were given Friday AM before supplies ran out. And an additional 150 when stock was replenished.B821841584Z.1_20150123191304_000_GGS1DL62B.2_Gallery

The shots are effective and reduce the risk of illnesses. Earlier this month, a similar exposure incident in New Jersey resulted in additional cases amongst folk who didn’t stand in line for shots.

“It’s unfortunate, really,” said Joanne Hall, a clerk of session at the St. Andrew’s Presbyterian Church down the street from the restaurant. “It’s a business, and something like this is not something you ask for. It can happen anywhere. As a small community we will support them, and help them get back on their feet.”

Anyone who dined at Marj’s between Jan. 2 and Jan. 20—the period when there was the highest likelihood of infection— was advised to get vaccinated to prevent infection.

Marj’s was closed on Friday, but not due to a public health order. Health officials inspected the premises on Thursday and cleared it. The restaurant’s owner, Keith Mclean, was not immediately available for comment. There were a number of people in the back of the diner Friday who appeared to be readying it for business. 

John Goforth lives just around the corner from Marj’s and eats there occasionally. He has not dined there this month and is not getting the vaccination.

“It’s a really good place, with good people and good food,” he said. “There was nothing they could do about this (except require vaccinations for their staff? -ben), and I hope it doesn’t hurt them. It’s been there forever, and it’s a great place.” 

“I think it was just a fluke,” Arsene Pick said Friday after getting the shot. He lives in Elora and dines occasionally at Marj’s. “It was just one of the cooks there that caught it and nobody knew. I hope it doesn’t hurt their business.”

Sharon Grose was in the outside lineup Friday. She said Marj’s is legendary in Alma, and is frequented by people from all around the town, especially in the farming community, and by travellers on their way to cottages further north. 

“This is a small price to pay to make sure you’re safe,” she said, speaking of waiting in the lineup for the vaccine. She had been waiting for about 40 minutes. “I don’t think this will hurt Marj’s. I hope not. They have a solid record for good food. This is just a matter of people being cautious.” 

Canadians are so nice.

Marj’s in Alma, Ontario source of hepatitis A exposure

When I was a grad student I played in a few co-ed slopitch baseball tournaments close to Guelph, Ontario (that’s in Canada). These tournaments consisted of a lot of beer drinking and my team (which completed in the Guelph restaurant league) wasn’t great. We played one tournament in Palmerston and on the way home we stopped for greasy hamburgers at a place called Marj’s in Alma. I don’t remember much about the meal. Just that we stopped.logo

Marj’s, according to the Guelph Mercury, is dealing with a hepatitis A exposure situation.

Anyone who ate at Marj’s Village Kitchen in Alma between Jan. 2 and 20 is advised to get a Hepatitis A vaccination as soon as possible, Wellington-Dufferin-Guelph Public Health reports. 

Dr. Nicola Mercer, medical officer of health, has confirmed that an employee at the restaurant has a confirmed case of Hepatitis A and anyone who ate there in the first part of January could be at risk of infection.

“The source is no longer working at the restaurant so there is no further risk at this restaurant,” Mercer said in an interview. “We are not out to be punitive.

“But Marj’s is extremely popular—it’s always busy. There could be many hundreds who have been exposed.”

Mercer is urging customers who ate at the restaurant between Jan. 2 and Jan. 20 to get a Hepatitis A vaccine as soon as possible.

UK: Toilet waste from older trains risks workers health, union claims

Rail workers’ health is being risked by sewage flushed from older coaches a union has said, with one-in-10 coaches in the UK still released toilet waste on to the tracks

THE-SHIT-TRAIN-300x168Ken Usher, from the Rail Maritime and Transport Union (RMT),

said train workers were at risk of contracting infections and illnesses such as hepatitis and E. coli from being in contact with sewage.

“Working trackside is a dirty job at the best of times – if you are sprayed with effluent it makes it even worse.

“If you can imagine a toilet being flushed at between 40 and 70 mph alongside you, you can get sprayed with just about any liquid and solids… not very nice at all,” he said.

Susan Lea, from Shotton in Flintshire, has a railway line at the bottom of her property, and has had toilet waste from a train blown into her garden.

“[It was] all over my washing, all over the garden, all over the fence, all over the chairs, all over the floor, it was everywhere.

“They wrote to me and told me that they’re allowed to drop this sewerage – it’s not fair on people older, like me, who have to clear it up if it does come in their garden.”

Seb Gordon, from RDG, told the BBC’s Inside Out West Midlands: “The rail safety board, the rail safety organization, has looked into [waste from trains] and has found that it’s a relatively low risk.”

Not taking hep A exposure seriously may have led to additional illness

Hamilton (NJ) Township health officer Jeff Plunkett held press conference on additional hepatitis A illnesses potentially linked to Rosa’s Restaurant and Catering today and the transcript was posted by the Times of Trenton.

Both individuals ate at the restaurant during the initial exposure window – one got an IgG shot (an employee of a spa), one did not (a fitness instructor at a local Y).


The biggest takeaway was this:

2:27 p.m.: The [yoga] instructor told Plunkett that she did not take the initial situation at Rosa’s seriously and did not get the vaccine.

Hep A is serious stuff.

Two additional cases of hepatitis A linked to Rosa’s Restaurant and Catering in Hamilton, NJ.

A big problem with hepatitis A is that a food handler can shed the virus for a month without showing symptoms – and an infected customer may not show symptoms for a few weeks either. An incident that looks like it is over can linger. According to Hamilton New Jersey health officials, the virus has spread from a food handler at Rosa’s Restaurant and Catering to a salon employee.

Here comes another round of IgG shots.gech_0001_0002_0_img0129

Hamilton officials confirmed two more cases of hepatitis A in the township a month after a food handler at Rosa’s Restaurant and Catering first contracted the virus.

Health officials were notified late Wednesday night by Robert Wood Johnson Hospital Hamilton and the state Department of Health that an employee of The Hair Port Salon on South Broad Street was diagnosed with hepatitis A. The employee has been released from the hospital and is recovering at home, officials said.

Staff and customers who visited the salon between Dec. 4 and Wednesday may be at risk of contracting the virus and should be vaccinated if they have not already done so, officials said.

In the second case, hepatitis A was confirmed Thursday in a fitness instructor at the Hamilton Area YMCA’s JKR branch on Whitehorse-Mercerville Road, officials said.

Officials confirmed that both individuals had eaten at or from Rosa’s during the first case, but could not say with certainty whether the two additional cases were a direct result. Just last week, township health officer Jeff Plunkett said the incubation period was set to end Jan. 11 and no new cases had emerged at the time.

Foodborne hepatitis A outbreak associated with bakery products in northern Germany, 2012

In October 2012, a hepatitis A (HA) outbreak with 83 laboratory-confirmed cases occurred in Lower Saxony.

german.bakeryWe defined primary outbreak cases as people with laboratory-confirmed HA and symptom onset between 8 October and 12 November 2012, residing in or visiting the affected districts. Secondary outbreak cases were persons with symptom onset after 12 November 2012 and close contact with primary cases. We identified 77 primary and six secondary cases. We enrolled 50 primary cases and 52 controls matched for age and sex, and found that 82% of cases and 60% of controls had consumed products from a particular bakery (OR=3.09; 95% CI: 1.15–8.68). Cases were more likely to have eaten sweet pastries (OR=5.74; 95% CI: 1.46–22.42). Viral isolates from five selected cases and three positively tested surfaces in the bakery had identical nucleotide sequences. One additional identical isolate derived from a salesperson of the bakery suffering from a chronic disease that required immunosuppressive treatment.

Epidemiological and laboratory findings suggested that the salesperson contaminated products while packing and selling. Future risk assessment should determine whether food handlers with chronic diseases under immunosuppressive treatment could be more at risk of contaminating food and might benefit from HAV immunisation.


Further Hepatitis A case in UK school

Health officials are planning to vaccinate all children and staff at a Portsmouth school following a further case of Hepatitis A.

hepatitis.AChildren from selected classes at Devonshire Infant School were vaccinated in November after seven cases of the infection in one family.

Public Health England (PHE) said the further case suggested “transmission may have occurred within the school”.

The vaccination is now being offered to all 180 pupils and about 30 staff.

It is also being offered as a precaution to the children and staff at Fledglings pre-school.

Vaccines work: Report shows sharp decline in U.S. hepatitis A cases

A new report shows there has been a sharp decline in hepatitis A cases throughout the United States. An analysis of federal data found that hospitalization rates have fallen from 7.2 to 2.9 patients per million patients admitted to hospitals from 2002 to 2011.

berry.blend.hep.aHepatitis A cases have fallen by almost 90 percent over the past 20 years marking this increased decline as another major step forward in the fight against the potentially deadly liver disease. Vaccines like Twinrix, which protect against both Hepatitis A and B, can make a big difference.

“Hepatitis A vaccination is very important for everyone, especially travelers to high risk countries,” said Melanie Kohr, Vice-President of Clinic Operations for Passport Health. “Travel trends are on the rise, and if more people are vaccinated against this potentially deadly disease, then the likelihood of spreading it when a traveler returns greatly declines. This can play a critical role in national health in the long term and for the health of close family members no matter the situation.”