According to local press reports, Westchester County has treated 250 people who may have been exposed to hepatitis A at Sleepy Hollow Country Club, officials said today.

Those people received preventive treatment after a club employee was infected by one of the five people who were exposed to hepatitis A at bartaco in Port Chester, said Caren Halbfinger, a spokeswoman for the Westchester Department of Health.

The department is offering free treatment at its clinic at 134 Court St. in White Plains for anyone who ate or drank at the club between Oct. 30 and Nov. 4.

The Health Department will offer hepatitis A vaccine to most people. Infants under 1 year old and people with immune-compromising conditions will be given immune globulin.

The county clinic is providing treatment from 9 a.m. to 4 p.m. today and Tuesday, 9 to 11 a.m. on Wednesday and Thursday, and 9 a.m. to 3 p.m. on Friday. Officials said treatment is most effective within two weeks of exposure.

Phelps Hospital in Sleepy Hollow is offering treatment for anyone who attended its gala at the country club on Nov. 3. Treatment is available at the hospital at 755 N. Broadway from 10 a.m. to 5 p.m. Monday through Friday this week.

Anyone who ate or drank at the club between Oct. 21 and Oct. 29 may also have been exposed, but the treatment is only effective within two weeks of exposure, officials said. Anyone who is too late for treatment is still urged to contact their health care provider immediately, though, so that anyone they may have exposed can receive treatment.

Health officials said they did not expect this outbreak to affect as many as people as bartaco’s outbreak, which included treatment of more than 3,000 people who were potentially exposed to hepatitis A.

CNBC reports that two more carriers, Delta Air Lines and Virgin Australia, have suspended service from an onboard catering facility in Los Angeles International Airport after it detected listeria there in a recent inspection.

Earlier this month American Airlines said it had halted deliveries from the Gate Gourmet facility after the bacteria was detected there.

Listeria, which can cause fever and diarrhea and can be fatal in some cases, was detected during a safety audit at the Los Angeles kitchen, Gate Gourmet said. The company said the traces of the bacteria were found in areas such as floor drains that do not come into contact with passenger food.

The Los Angeles airport facility is still open and operating, said Catherine Nugent, a Gate Gourmet spokeswoman.

“We can’t comment on behalf of our customers, but we remain committed to delivering a safe and efficient service,” she said.

Delta spokeswoman Catherine Sirna said the kitchen is in compliance with local and federal regulations but that the airline decided to suspend deliveries from the facility “out of an abundance of caution for the health and safety of our customers.”

Onboard meals will remain the same, she added.

A spokesperson for Virgin Australia said, “Over the coming days there will be limited catering available on flights from Los Angeles.”

As an alternative it will offer vouchers to passengers to purchase food before the flight.

The New Jersey Department of Health (DOH) on Friday issued cease-and-desist orders to Udder Milk, a home delivery company that has illegally sold unpasteurized milk in New Jersey. State and federal officials are investigating to determine from which farms Udder Milk acquired its raw milk, after a North Jersey woman became ill with a rare bacterial infection.

“It is illegal in New Jersey to sell or distribute raw milk or products made from raw milk, such as yogurt, soft cheese and ice cream,” State Epidemiologist Dr. Tina Tan said. “People should know that, in general, unpasteurized milk may contain dangerous bacteria and those who have become ill after consuming raw milk products should immediately consult a medical professional. Pasteurized milk and dairy products bought commercially are considered safe for consumption, because they are heated to a high temperature that kills harmful bacteria.”

The United States Department of Agriculture (USDA), the Centers for Disease Control and Prevention (CDC) and the Department’s Public Health and Food Protection Program, with the cooperation of the New Jersey Department of Agriculture, are investigating to determine the suppliers.

DOH was notified on Oct. 23 that a North Jersey woman tested positive for Brucella RB51 infection, and she has since recovered. It marked the second case associated with raw milk consumption confirmed in the United States this year. The Texas Department of State Health Services, with assistance from CDC, is investigating Brucella abortus RB51 exposures and illnesses connected to a dairy company in Paradise, Texas that also sells raw milk products.

Brucella bacteria are primarily passed among infected animals. While rare, people can become infected by eating or drinking contaminated raw milk products. A Brucellosis infection can cause a range of symptoms including fever, sweats, chills, weight loss, headache, fatigue and muscle and joint pain. Symptoms may appear up to six months after exposure. In severe cases, infections of the central nervous system or lining of the heart may occur. People who may have consumed contaminated milk should see a doctor right away. Brucella RB51 cannot be diagnosed through tests commonly used to diagnose the disease, and this strain is resistant to one of the antibiotics commonly used to treat brucellosis in people.

From 1993 through 2012, 127 outbreaks linked to raw milk were reported to CDC, resulting in 1,909 illnesses and 144 hospitalizations. Between 2012 and 2016, only three New Jersey cases were reported.

Homelessness in the greater Seattle/King County region seems to be rising as fast as High-Tech jobs and housing prices.  There are estimated to be 3,000 people in Seattle each night who are unsheltered and about 10,000 homeless people living on either the streets or in shelters. And, as the nights grow wetter and colder, the lives of our fellow citizens grow even more precarious.  Clearly, homelessness is a complex issue that combines various elements of poverty, substance abuse and mental health, however, now, enters yet another concern – public health – specifically, the growing risk of hepatitis A amongst the homeless, and the risk that it will spread.

It is what is happening in other regions and the risk that it could happen here is real.

In the Detroit, Michigan area there have been 486 cases of hepatitis A, including 19 fatalities, identified as related to an outbreak in Southeast Michigan, according to the Michigan Department of Health and Human Services. In October, health officials said they were investigating cases at Firewater Bar and Grill and a Little Caesars Pizza location in Detroit and a restaurant worker in Ann Arbor. Cases were also linked to Whole Foods in Detroit and Social Kitchen in Birmingham and recently at Champs Rotisserie and Spirits in Wayne County.

In San Diego, California, the county Health and Human Services Agency published new weekly totals, which add one to the number of deaths recorded since the health crisis started in November 2016. The running tally of confirmed cases also continues to increase, reaching 536 from a previous total of 516 – including 20 deaths. On September 15th, the county notified the public that a worker at World Famous restaurant in Pacific Beach had tested positive.

And, thanks to the Huffington Post, you can see the problem in the whole country:

Hepatitis A is preventable with a vaccine and/or good sanitation and/or handwashing. Hepatitis A is a communicable — or contagious — disease that often spreads from person to person. Person-to-person transmission occurs via the “fecal-oral route,” while all other exposure is generally attributable to contaminated food or water.

Hepatitis A is relatively stable and can survive for several hours on fingertips and hands. It can live up to two months on dry surfaces. The virus can be inactivated by heating to 185 degrees F (85°C) or higher for one minute, or disinfecting surfaces with a 1:100 dilution of sodium hypochlorite (household bleach) in tap water. Freezing does not kill the virus.

The vaccine is recommended by public health officials for the following people:

  • Travelers to areas with increased rates of hepatitis A;
  • Men who have sex with men;
  • Injecting and non-injecting drug users;
  • Persons with clotting factor disorders;
  • Persons with chronic liver disease;
  • Persons with occupational risk of infection;
  • Children living in regions of the U.S. with increased rates of hepatitis A; and
  • Household members and other close personal contacts.

So, what can we do to prevent the tragedies that have hit California and Michigan hard and appear to be spreading to other areas of the country?

  • Encourage and offer hepatitis A vaccines to the homeless and other at-risk members of the public;
  • Provide sanitary bathroom and handwashing facilities to the homeless; and
  • Provide assistance to our neighbors to deal with the underlying issues of poverty, substance abuse and mental health.

Pride & Joy Dairy, a Toppenish, Washington, raw milk dairy has surrendered its processors license, though it could regain the license by satisfying the state Department of Agriculture (WSDA) that it has found and cleaned up the source of Salmonella.

WSDA suspended the dairy’s license on October 6 after state health officials linked raw milk from Pride & Joy to two people hospitalized in January with Salmonella poisoning.

If Pride & Joy had not surrendered its license, the dairy faced having the license revoked by WSDA.

The dairy agreed that it must submit a plan for WSDA’s approval for investigating the cause of pathogens in its bottled milk and for correcting problems.

WSDA reported finding Salmonella in raw milk samples collected from the dairy in September. WSDA issued a public health alert after the dairy declined to voluntarily recall its milk.

As I said before – “For Goodness Sake – Vaccinate”

Management of Champs Rotisserie and Spirits at 20515 Mack Ave. alerted the Wayne County Department of Health, Veterans and Community Wellness to the issue.

Hepatitis A is spread through contaminated food or water, or close personal contact with an infected person.

The ill employee is not working and is receiving medical care, the health department said in a news release.

Health officials say those who ate food from the restaurant on or after Oct. 20 should get a vaccine by Nov. 13 if they have not already been vaccinated. People who consumed food from the restaurant Oct. 10-30 should watch for symptoms of hepatitis A, which can include abdominal pain, nausea, vomiting, diarrhea, dark urine, clay colored stool, fever, chills and jaundice. Symptoms occur 15-50 days after exposure and can last for several weeks to months.

Since Aug. 1, 2016, there have been 486 cases of hepatitis A, including 19 fatalities,  identified as related to an outbreak in Southeast Michigan, according to the Michigan Department of Health and Human Services.

In October, health officials said they were investigating cases at Firewater Bar and Grill and a Little Caesars Pizza location in Detroit and a restaurant worker in Ann Arbor. Cases last year were linked to Whole Foods in Detroit and Social Kitchen in Birmingham, and a pizza restaurant in Alabama.

In San Diego California, the county Health and Human Services Agency published new weekly totals, which add one to the number of deaths recorded since the health crisis started in November 2016. The running tally of confirmed cases also continues to increase, reaching 536 from a previous total of 516 – including 20 deaths. On September 15th the county notified the public that a worker at World Famous restaurant in Pacific Beach had tested positive.

And, thanks to the Huffington Post, you can see the problem in the whole country:

According to the FDA, the CDC reports a total of 251 people were infected with the outbreak strains of Salmonella Thompson (144), Kiambu (54), Anatum (20), Agona (12), Gaminara (7), Urbana (7), Newport & Infantis (4), and Senftenberg (3), from 25 states.

Seventy-nine ill people were hospitalized. Two deaths were reported, one from New York City and one in California.

Outbreak Investigations Linked to Papayas:

Not  to be confused with the Seven Deadly Sins: pride, greed, lust, envy, gluttony, wrath and sloth, although, perhaps some of these outbreaks were sinful.  I had the honor to represent many of the ill and the families of those who died.

Jack-in-the- Box E. coli Outbreak – 1992 – 1993

708 ill, 171 hospitalized and 4 dead

An outbreak of E. coli O157:H7 was linked to the consumption of hamburgers from the Jack-in-the-Box Restaurant chain. Cases were reported from the states of Washington (602 cases/144 hospitalizations/3 deaths), Idaho (14 cases/4 hospitalizations/no deaths), California (34 cases/14 hospitalizations/1 death), and Nevada (58 cases/9 hospitalizations/no deaths). A case control study implicated the chain’s hamburgers resulting in a multistate recall of the remaining hamburgers. Only 20 percent of the product remained at the time of the recall; this amounted to 272,672 hamburger patties. Subsequent testing of the hamburger patties showed the presence of E. coli O157:H7. The strain of E. coli O157:H7 found in ill people matched the strain isolated from uncooked hamburger patties. The outbreak illustrated the potential for large, foodborne illness outbreaks associated with restaurant chains receiving shipments of contaminated food. At the time, many clinical laboratories in the United States were not routinely culturing patients’ stool for E. coli O157:H7 by using the correct culture medium. Additionally, many local and state health departments were not actively tracking and investigating E. coli O157:H7 cases.


Chi Chi’s Green Onion Hepatitis A Outbreak – 2003

565 ill, 130 hospitalized and 3 dead

Pennsylvania State health officials first learned of a hepatitis A outbreak when unusually high numbers of hepatitis A cases were reported in late October 2003. All but one of the initial cases had eaten at the Chi Chi’s restaurant at the Beaver Valley Mall, in Monaca, PA. Ultimately, at least 565 cases were confirmed. The victims included at least 13 employees of the Chi Chi’s restaurant, and residents of six other states. Three people died as a consequence of their hepatitis A illnesses. More than 9,000 people who had eaten at the restaurant, or who had been exposed to ill people, were given a post-exposure injection as a prevention against developing hepatitis A. Preliminary analysis of a case-control study indicated fresh, green onions were the probable source of this outbreak. The investigation and tracebacks by the state health department, the CDC, and the FDA, confirmed that the green onions had been grown in Mexico.


Dole Baby Spinach E. coli Outbreak – 2006

238 ill, 103 hospitalized and 5 dead

On Sept. 13, 2006, public health officials in Wisconsin, Oregon and New Mexico noted E. coli O157:H7 infections with matching pulsed-field gel electrophoresis (PFGE) patterns. These illnesses were associated with eating fresh, bagged spinach produced by Dole Brand Natural Selection Foods. By Sept. 26 that year, infections involving the same strain of E. coli O157:H7 had been reported from 26 states with one case in Canada. A voluntary recall was issued by the company on Sept. 15. E. coli O157: H7 was isolated from 13 packages of spinach supplied by patients in 10 states. Eleven of the packages had lot codes consistent with a single manufacturing facility on a particular day. The PFGE pattern of all tested packages matched the PFGE pattern of the outbreak strain. The spinach had been grown in three California counties – Monterey, San Benito and Santa Clara. E. coli O157:H7 was found in environmental samples collected near each of the four fields that provided spinach for the product, as designated by the lot code. However, E. coli O157:H7 isolates associated with only one of the four fields, located on the Paicines Ranch in San Benito County, had a PFGE pattern indistinguishable from the outbreak strain. The PFGE pattern was identified in river water, cattle feces and wild pig feces on the Paicines Ranch, the closest of which was less than one mile from the spinach field.


Peanut Corporation of America Salmonella Outbreak – 2008 – 2009

714 ill, 171 hospitalized and 9 dead

Beginning in November 2008, CDC’s PulseNet staff noted a small and highly dispersed, multistate cluster of Salmonella Typhimurium isolates. The outbreak consisted of two pulsed-field gel electrophoresis (PFGE) defined clusters of illness. Illnesses continued to be revealed through April 2009, when the last CDC report on the outbreak was published. Peanut butter and products containing peanut butted produced at the Peanut Corporation of America plant in Blakely, GA, were implicated. King Nut brand peanut butter was sold to institutional settings. Peanut paste was sold to many food companies for use as an ingredient. Implicated peanut products were sold widely throughout the USA, 23 countries and non-U.S. territories. Criminal sanctions were brought against the owners of PCA.


Jensen Farms Cantaloupe Listeria Outbreak – 2011

147 ill, 143 hospitalized and 33 dead

A multistate outbreak of Listeria monocytogenes involving five distinct strains was associated with consumption of cantaloupe grown at Jensen Farms’ production fields near Granada, CO. A total of 147 ill people were reported to the CDC. Thirty-three people died, and one pregnant woman miscarried. Seven of the illnesses were related to pregnancy – three newborns and four pregnant women. Among 145 ill people with available information, 143 – 99 percent – were hospitalized. Source tracing of the cantaloupes indicated that they came from Jensen Farms, and were marketed as being from the Rocky Ford region. The cantaloupes were shipped from July 29 through Sept. 10, 2011, to at least 24 states, and possibly distributed elsewhere. Laboratory testing by the Colorado Department of Public Health and Environment identified Listeria monocytogenes bacteria on cantaloupes collected from grocery stores and from ill persons’ homes. Laboratory testing by FDA identified Listeria monocytogenes matching outbreak strains in samples from equipment and cantaloupe at the Jensen Farms’ packing facility in Granada, Colorado.  Criminal sanctions were brought against the two owners of Jensen Farms.


Bidart Caramel Apple Listeria Outbreak

35 ill, 34 hospitalized and 7 deaths

On December 19, 2014, the CDC announced a multistate outbreak of Listeria monocytogenes linked to commercially produced, prepackaged caramel apples. A total of 35 people infected with the outbreak strains of Listeria monocytogenes were reported from 12 states. Of these, 34 were hospitalized. Listeriosis contributed to at least 3 of the 7 deaths reported. Eleven illnesses were pregnancy-related with one illness resulting in a fetal loss. here invasive illnesses were among otherwise healthy children aged 5-15 years. Twenty-eight (905) of the 31 ill persons interviewed reported eating commercially produced, prepackaged caramel apples before becoming ill. The Public Health Agency of Canada identified one case of listeriosis that was genetically related to the US outbreak. The investigation was assigned Cluster ID #1411MNGX6-1. On December 24, 2014, Happy Apples issued a voluntary recall of Happy Apple brand caramel apples with best use by date between August 25th and November 23rd, 2014 due to a connection between the apples and outbreak associated cases. California Snack Foods brand caramel apples issued a similar recall on December 27th. Both companies used apples supplied by Bidart Brothers. On December 29 Merb’s Candies recalled Bionic Apples and Double Dipped Apples. On January 6, 2105 Bidart Bros. of Bakersfield, California recalled Granny Smith and Gala apples because environmental testing revealed contamination with Listeria monocytogenes at the firm’s apple-packing facility. On January 8, 2015 FDA laboratory analyses using PFGE showed that environmental Listeria isolates from the Bidart Bros. facility were indistinguishable from the outbreak strains.


Andrew and Williamson Cucumber Salmonella Outbreak – 2015

907 ill, 204 hospitalized and 6 dead

On September 4, 2015 the CDC announced an outbreak of Salmonella Poona linked to consumption of cucumbers grown in Mexico and imported by Andrew & Williamson Fresh Produce. On March 18, 2016 the outbreak was declared to be over. A total of 907 people infected with the outbreak strains of Salmonella Poona were reported from 40 states. Among people for whom information was available, illnesses started on dates ranging from July 3, 2015 to February 29, 2016. Two hundred four ill people were hospitalized and six deaths were reported. Salmonella infection was not considered to be a contributing factor in two of the 6 deaths. Epidemiologic, laboratory, and traceback investigations identified imported cucumbers from Mexico and distributed by Andrew & Williamson Fresh Produce as the likely source of the infections in this outbreak.

So, sang John Denver – Almost.

American Airlines has temporarily stopped using a catering facility at Los Angeles International Airport after traces of the bacteria listeria, which can cause severe food poisoning, were detected in the kitchen, the company said Wednesday.

The bacteria was detected on floors and in drains during a routine inspection of the kitchen operated by Gate Gourmet, but not on surfaces that come in contact with food, according to American. There have been no reports of passengers or employees being affected by listeriosis, the illness caused by listeria.

An estimated 1,600 people get sick, and about 260 die, from listeriosis each year, usually by consuming foods contaminated with the bacteria listeria, according to the CDC. Symptoms can include fever, muscle aches and nausea or diarrhea. Pregnant women, newborns and people over age 65 are especially vulnerable.

According to health reports, about 180 people reported becoming ill after the event and around half of those sought medical care, with 20 percent receiving emergency room care — 10 percent were hospitalized for one or more nights after eating chowder from the Crab Shack at the Chincoteague Chili Chowder Cook Off in late September.

However, Dr. David Matson made it clear Thursday that is was more important to suck up to the place that sickened 180 people with Salmonella.

“The risk is gone,” said the Eastern Shore Health District director. Matson traveled from the health department in Accomac about 45 minutes north to Chincoteague on Thursday to eat lunch. It was more than a mere lunch. The meal at the Crab Shack on Maddox Boulevard was Matson’s statement to the public — an endorsement, if you will —  that the restaurant’s award-winning clam chowder is safe.

It was also tasty — a lightly creamy, savory broth chock full of clams, along with potatoes, celery and carrots, with a hint of bacon, he said.

The health department on Monday identified the site as the source of a salmonella outbreak that occurred after the Chincoteague Chili Chowder Cook Off in late September. The establishment was identified in a news release Tuesday from the health district because there were additional ones also serving chowder at the event.