The Hawaii Department of Health is investigating two cases of hepatitis A in Kauai residents.
Symptoms began in November 2017, and health officials say the strain of the virus in both cases appears to be the same one currently circulating in California.
Dr. Sarah Park, state epidemiologist, says the two cases appear to be unrelated.
One traveled to California, but “for the other case, we’ve not been able to discern any type of travel, so that becomes concerning,” Park said. “Potentially this strain has been introduced into Hawaii and we don’t know if it’s just going to be this small cluster, a focused cluster, or larger.”
California’s hepatitis A outbreak originated in San Diego and has spread statewide and to other states.
The outbreak was identified in early March 2017, and prompted the San Diego County public health officer to declare a local public health emergency in September. The majority of the cases were among people who were homeless, used illicit drugs, or a combination of the two.
Localized data out of San Diego as of Jan. 2, 2018 puts the total number of cases there at 577 with 20 deaths and 396 hospitalizations.
Hawaii travelers to the mainland may become infected during their visit and can accidentally bring that infection home with them.
The virus is found in the stool of people with hepatitis A infection and is usually spread through close personal or sexual contact as well as by eating contaminated food or drinking water. A person who has hepatitis A can easily pass the disease to others within the same household.
It’s a good reminder, Park says, for residents to get vaccinated for long-term immunity.
“As our investigators continue their work, we want to remind Hawaii residents that hepatitis A vaccination is highly effective in preventing infection,” she said. “With large, multi-state outbreaks occurring across the country, it is important that we all take precautions to prevent hepatitis A infection whether at home, work, recreating, or traveling.”
While vaccination provides the best protection, frequent handwashing with soap and warm water after using the bathroom, changing a diaper, or before preparing food can help prevent the spread of hepatitis A. Appropriately cooking food and using safe food handling practices can also help prevent infection.
Hepatitis A is a virus that can cause fever, fatigue, loss of appetite, abdominal discomfort, dark urine, diarrhea, and yellow skin and eyes. Symptoms typically last several weeks to as long as two months. Persons should seek medical attention immediately should they develop symptoms.
The hepatitis A vaccine is included in routine childhood immunizations at age 1 and is recommended for adults who are at risk or want to protect themselves from hepatitis A. People are encouraged to complete the two-dose vaccine series to assure long-term immunity.
Individuals who want to be vaccinated are encouraged to contact their health care provider.
A medical advisory has recently been distributed by DOH to physicians statewide.