From January 1, 2019 through January 31, 2019, 189 hepatitis A cases were reported in 26 counties.

The number of reported hepatitis A cases more than doubled from 2016 to 2017 after remaining relatively stable in previous years. Case counts in January 2019 are higher than those seen in January of previous years.

The number of reported hepatitis A cases steadily increased each month since April 2018 and remained above the previous 5-year average in January 2019. The number of cases reported in January increased from the previous month.

The 189 hepatitis A cases in January were reported in the 26 counties outlined in black. The central Florida region had the highest hepatitis A activity levels. Since January 1, 2018, 97% of cases have likely been acquired locally in Florida.

A preliminary settlement of up to $4,500,000.00 has been reached in a class action lawsuit filed on behalf of those who were exposed to hepatitis A related to eating at Genki Sushi restaurants in Hawaii in 2016, but who did not become ill with hepatitis A. The class is represented by Seattle based, Marler Clark, the nation’s food safety law firm, Perkin and Faria, and Starn, O’Toole, Marcus, and Fisher, respected Hawaii firms.  See 

Genki-Stipulation for Order Stipulating Class filed 10.12.18

Genki-Order Approving Stipulation for Class Certification filed 10.12.18

Qualified class members are entitled to receive up to either $350, $250, or $150 by submitting a claim form available at or by calling 1-800-532-9250.

The hepatitis A outbreak:

On August 15, 2016, the Hawaii Department of Health (HDOH) identified raw scallops served at Genki Sushi restaurants on Oahu and Kauai as a likely source of an ongoing hepatitis A outbreak. The product of concern was identified to be Sea Port Bay Scallops that originated in the Philippines and were distributed by Koha Oriental Foods.

The class is defined as follows:

All persons who: (1) as a result of the 2016 Hepatitis A Outbreak infections linked to consuming food at thirteen Genki Sushi restaurants located on the islands of Oahu, Kauai, and Maui, were exposed to the hepatitis A virus (“HAV”) through one of three exposure-mechanisms (defined in the Exposure Subclasses), but did not become infected, and (2) as a result of such exposure, after learning of the requirement of treatment from an announcement of public health officials or a medical professional, obtained preventative medical treatment within 14 days of exposure, such as receiving immune globulin (“IG”), HAV vaccine, or blood test.

The preliminary settlement covers three subclasses:

Exposure Subclass 1 – up to $350: All Class Members who were in contact with one of the 292 persons who the Hawai’i Department of Health identified as infected with HAV as part of the 2016 Hepatitis A Outbreak. A contact is defined as:

  • All household members of one of the 292 persons
  • All sexual contacts with one of the 292 persons
  • Anyone sharing illicit drugs with one of the 292 persons
  • Anyone sharing food or eating or drinking utensils with one of the 292 persons
  • Anyone consuming ready-to-eat foods prepared by one of the 292 persons

Exposure Subclass 2 – up to $250: All Class Members who as a result of consuming food on or between August 1 to August 16, 2016, were exposed to HAV at one of the thirteen Genki Sushi restaurants located on the islands of Oahu, Kauai, and Maui, implicated in the summer 2016 outbreak of HAV.

Exposure Subclass 3 – up to $150: All Class Members who as a result of consumption of food or drink from one or more of the Secondary Establishments identified below, where an employee infected as part of the 2016 Hepatitis A Outbreak (one of the 292 persons) was found to have worked on the Identified Dates, were exposed as a result of consuming food or drink at the Secondary Establishment during one or more of the Identified Dates. The Secondary Establishments and Identified Dates are as follows:

  • Baskin Robbins located at Waikele Center, HI 96797: June 30 and July 1, 2, 2016;
  • Taco Bell located at 94-790 Uke’e St., Waipahu, HI 96797: July 1, 3, 4, 6, 7, 11, 2016;
  • Sushi Shiono located at 69-201 Waikoloa Beach Drive, Waikoloa, HI 96738: July 12, 13, 14, 15, 18, 19, 20, 21, 2016;
  • Chili’s Grill & Bar located at 590 Farrington Hwy, Kapoelei, HI 96707: July 20, 21, 22, 23, 25, 26, 27, 2016;
  • Twelve Hawaiian Airlines flights (24) flight 118 on July 24; (25) flight 117 on July 24; (26) flight 382 on July 24; (27) flight 383 on July 24; (28) flight 396 on July 24; (29) flight 365 on July 24; (30) flight 273 on July 25; (31) flight 68 on July 25; (32) flight 65 on July 25; (33) flight 147 on July 26;; (36) flight 18 on August 10; and (37) flight 17 on August 12, 2016;
  • Tamashiro Market located at 802 N. King St., Honolulu, HI 96817: July 23, 2016;
  • Papa John’s located at 94-1012 Waipahu St., Waipahu, HI 96797: August 2, 2016;
  • New Lin Fong Bakery located at 1132 Maunakea St., Honolulu, HI 96817: July 27, 29, 30, and August 1, 3, 5, 6, 2016;
  • Hokkaido Ramen Santouka, located at 801 Kaheka St., Honolulu, HI 96814: and August 3, 4, 5, 6, 9, 10, 11, 2016;
  • Kipapa Elementary School located at 95-76 Kipapa Dr., Mililani, HI 96789: August 10, 11, 12, 13, 14, 15, 16, 2016;
  • Zippy’s Restaurant located at 950 Kamokila Blvd., Kapolei, HI 96707: August 14, 18, 19, 21, 23, 25, 26, 2016;
  • Harbor Restaurant at Pier 38 located at 1133 North Nimitz Hwy, Honolulu, HI 96817: August 30-31 and September 1- 12, 2016;
  • Ohana Seafood at Sam’s Club located at 1000 Kamehameha Hwy., Pearl City, HI 96782: September 1- 11, 2016;
  • Chart House Restaurant located at 1765 Ala Moana Boulevard, Honolulu, HI 96815: September 4, 8, 9, 10, 11, 2016; and
  • McDonald’s Restaurant located at 4618 Kilauea Avenue, Honolulu, HI 96816: October 5, 7, 11, 2016.

Key dates for claimants to be aware of:

On October 15, 2018, the Notice Company will establish a website for this Settlement at which will include electronic copies of the Claim form, the Notice of Settlement for publication, the Preliminary Approval Order, and other information pertaining to the Settlement.

Beginning on or promptly after October 15, 2018, the Notice Company shall commence an online or social media campaign, to include Facebook, Instagram, or such other social media as the Notice Company deems appropriate, to disseminate notice of the Settlement

Beginning on or promptly after October 15, 2018, the Notice Company shall cause the Notice of Settlement for publication to be published once a week for two consecutive weeks in the Honolulu Star Advertiser on Oahu, Hawai’i, and Maui as a paid legal advertisement

The deadline for Class Members to request exclusion from the Class, to file objections to the Settlement, or to submit a Claim Form, shall be November 29, 2018.

A Final Approval Hearing shall be held on December 11, 2018 in the Circuit Court of the First Circuit, Hawaii, before the Honorable Judge James H. Ashford for the purpose of determining: (a) whether the proposed settlement is fair, reasonable, and adequate and should be finally approved by the Court; and (b) whether to issue a final judgment order.

The Journal-Times reports that the Ashland-Boyd County Kentucky Health Department investigated a case of Hepatitis A diagnosed on May 23 in an employee who worked at McDonald’s Restaurant located at 2550 Winchester Avenue in Ashland, Kentucky.

The investigation found that the risk of restaurant patrons becoming infected was very low. However, McDonald’s is working with the health department to prevent any new cases from arising in the community as a result of this case. All employees, including the diagnosed case, received the Hepatitis A vaccine prior to the May 23 diagnosis. The Winchester Avenue McDonald’s voluntarily closed after notification of the confirmed case to complete extensive disinfection of the facility.

Interesting, the Journal-Times reported that the McDonald’s chain previously established a required hepatitis A vaccination policy for all workers.

This is great, considering a hepatitis A outbreak that has sickened thousands and killed dozens in California, Utah, Michigan, Arizona, Indiana, Kentucky and West Virginia and likely other states, has been brewing for a year.

On May 26 according to WSAZ, a case of hepatitis A was diagnosed in a food worker at the McDonald’s in Grayson, Kentucky. The McDonald’s is located along Carol Malone Boulevard in Grayson.

The Carter County Health Department says all employees at the restaurant received the hepatitis A vaccine before the diagnosis, including the person who was diagnosed. The restaurant closed voluntarily after notification about the diagnosis to sanitize the facility.

The corporate office brought in crews on Saturday, the day of the diagnosis, who disinfected the restaurant. Health officials say the risk of becoming infected if you ate at the restaurant is very low, however, the Carter County Health Department is working with McDonald’s to prevent any new cases from arising.

You have to wonder what the impetus of vaccinating food service workers was?

According to Business Insider, on April 11, 2018 McDonald’s stock dropped on following reports of an investigation of an employee who handled food while infected with hepatitis A. On Thursday, the health department of Madison County, Kentucky, reported it is investigating a single case of hepatitis A linked to an employee working while infectious at a McDonald’s in the town of Berea.

Whatever the motive, great job Ronald.

Do these ladies look like they might have hepatitis A?

According to Live Science, Kentucky Derby fans may need to take some extra precautions before heading off to the races.

The Indiana State Department of Health is recommending that its residents get vaccinated against hepatitis A and take other steps to protect themselves from the illness before traveling to Kentucky or Michigan, both of which are experiencing large outbreaks of the viral infection.

Kentucky has reported more than 300 cases of hepatitis A since November 2017, with 39 new cases reported in the first week of April, according to the Kentucky Department for Public Health. Most cases in the state have occurred around Louisville — the city where the Kentucky Derby is held. The famous horse race, which draws more than 150,000 people each year, takes place on the first Saturday in May.

I remember the first time I traveled outside the US, I got a series of vaccine – including a Hepatitis A vaccine.  I do not recall ever seeing a warning about travel within the US – go figure.

Indiana health officials are advising residents to get vaccinated for hepatitis A if their summer plans include visits to Kentucky or Michigan.

The Department of Health says significant outbreaks of the liver-damaging hepatitis A virus have been reported in Kentucky and Michigan.

The agency says Kentucky has seen more than 300 cases of the highly contagious viral infection, including three deaths, most of those in the Louisville area. Michigan has had more than 800 cases, including 25 deaths.

Indiana typically sees less than 20 hepatitis cases each year, but 77 have been confirmed since January.

State Epidemiologist Pam Pontones says getting vaccinated for hepatitis A and thoroughly washing hands when preparing food are “simple, safe and effective ways” to prevent the spread of hepatitis A.

Likely not so good for tourism?

A vaccine for all employees is good for customers and good for business.

According to a press release, the Madison County Kentucky Health Department is investigating a single case of hepatitis A in a food handler who worked while infectious at McDonalds restaurant on Glades Road in Berea, KY on March 23, 2018. Hepatitis A is caused by a virus that is passed person to person through fecal-oral contact. The risk to patrons who ate at McDonalds is very low. However, individuals who ate there on March 23rd, should watch for signs and symptoms of hepatitis A from April 7th to May 12th.

Hepatitis A can be spread when: an infected person does not wash his or her hands properly after going to the bathroom and then touches objects or food; a caregiver does not properly wash his or her hands after changing diapers or cleaning up the stool of an infected person; someone engages in certain sexual activities. Hepatitis A can also be spread through food or water through an ill food handler or by using contaminated items.

Symptoms of infection usually appear 15 to 50 days after exposure and can include: fever, jaundice, grey-colored stools, dark urine, abdominal pain, vomiting, fatigue, loss of appetite, nausea and joint pain. Some people, especially children, may have no symptoms. This is why proper handwashing is critical. Symptoms usually resolve in 2 months but can last as long as 6 months. There is no treatment for Hepatitis A and some people require hospitalization. If you have these symptoms you should contact your primary care provider for testing.

Hepatitis A can be prevented by receiving the Hepatitis A vaccination. This vaccination is available to anyone 12 months of age or older and is given in two doses six months apart. Everyone is also reminded that handwashing is the best way to prevent infection. Handwashing should be emphasized especially after using the bathroom, changing a diaper or preparing and eating food.

And, then there is the impact on stock price:

272 with Hepatitis A in Kentucky – Full Report

Employees at two local Louisville, Kentucky businesses have been diagnosed with Hepatitis A.

That has been a similar and common headline in newspapers across the country over the last several months.

One worker at Sarino (1030 Goss Avenue) was diagnosed. Customers who dined at the establishment from February 24 through March 15 may have been exposed to the virus. One worker from Kroger (520 N 35th Street) was diagnosed. Customers who shopped at the store from March 2 through March 19 may have been exposed to the virus.


Since Jan. 1, 2017, the Kentucky Department for Public Health (KDPH) has identified 198 confirmed cases of acute hepatitis A, a liver disease caused by hepatitis A virus. An increase in cases since Aug. 1, 2017, primarily among the homeless and drug users, prompted declaration of a statewide outbreak in Nov. 2017. Viral sequencing has linked several outbreak-associated cases in Kentucky with outbreaks in California and Utah.

KDPH is working closely with the Centers for Disease Control and Prevention and local health departments to provide guidance and education to health professionals and at-risk populations. Treatment for acute hepatitis A generally involves supportive care, with specific complications treated as appropriate. Hepatitis A is a vaccine-preventable disease.

Counts as of Mar. 17, 2018

  • Total Outbreak: 198
  • Hospitalizations: 142
  • Deaths: 1


Since January 1, 2017, Utah public health has identified 226 confirmed cases of hepatitis A virus (HAV) infection; many among persons who are homeless and/or using illicit drugs. Several cases have been linked by investigation and/or viral sequencing to a national outbreak of hepatitis A involving cases in California and Arizona. Hospitalization rates of less than 40% have been described in previous hepatitis A outbreaks; however, other jurisdictions associated with this outbreak are reporting case hospitalization rates approaching 70%.


On Jan. 23, 2018, the San Diego County ended the local health emergency, declared on September 1, 2017, in response to the local hepatitis A outbreak. The action does not mean the outbreak is over, and the County will continue efforts it has taken to control the spread of the disease.  There has been a total of 586 illnesses, 401 hospitalizations and 20 deaths.


Arizona officials believe the local outbreak was mainly confined to homeless people in Maricopa County. The county recorded only 15 known cases and no deaths, and officials have detected no new Arizona cases since the end of May 2017.  The illnesses in Arizona were linked to a person who traveled from San Diego.


Since the beginning of the outbreak in August 2016, the Michigan public health response has included increased healthcare awareness efforts, public notification and education, and outreach with vaccination clinics for high-risk populations. No common sources of food, beverages, or drugs have been identified as a potential source of infection. Transmission appears to be through direct person-to-person spread and illicit drug use. Those with history of injection and non-injection drug use, homelessness or transient housing, and incarceration are thought to be at greater risk in this outbreak setting. Notably, this outbreak has had a high hospitalization rate.  There has been a total of 789 illnesses, 635 hospitalizations and 25 deaths.

What about all the rest of the states?  What is the cause?  What is the source?  What can we do – in addition to vaccinations – to stop this?

Ill employee prompts Kroger to vaccinate employees but not customers.

According to Kentucky press reports, an employee in the produce department of the Kroger store at 4915 Dixie Highway has been diagnosed with Hepatitis A.

Kroger said the man worked at the store in Pleasure Ridge Park in February, and customers who bought produce between Feb. 4 to Feb. 28 may have been exposed to the virus. Any produce purchased during that time frame should be thrown away, Kroger said.

The employee worked third shift in the produce section and was diagnosed with Hepatitis A on Feb. 28 at a visit to the doctor. He immediately notified his supervisor, and Kroger notified the Health Department later that day, the company said.

Kroger said officials are cooperating with local and state health officials. Other employees threw away all the produce that the man is believed to have come in contact with and cleaned the store.

Additionally, Kroger is offering all associates and their families Hepatitis A vaccines. About 300 people work at the Pleasure Ridge Park store.

Hepatitis A can be transmitted through eating or drinking contaminated food or water. Symptoms include fatigue, loss of appetite, stomach pain, nausea and jaundice.

Since Jan. 1, 2017, the Kentucky Department for Public Health (KDPH) has identified 125 confirmed cases of acute hepatitis A, a liver disease caused by hepatitis A virus. An increase in cases since Aug. 1, 2017, primarily among the homeless and drug users, prompted declaration of a statewide outbreak in Nov. 2017. Viral sequencing has linked several outbreak-associated cases in Kentucky with outbreaks in California and Utah.

KDPH is working closely with the Centers for Disease Control and Prevention and local health departments to provide guidance and education to health professionals and at-risk populations. Treatment for acute hepatitis A generally involves supportive care, with specific complications treated as appropriate. Hepatitis A is a vaccine-preventable disease.

Counts as of Feb. 24, 2018

  • Total Outbreak: 125
  • Hospitalizations: 91
  • Deaths: 0

An employee who worked at the Lancaster restaurant Al-E-Oops and the Brookdale Williamsville Senior Living Facility may have exposed 346 patrons and nursing home residents to hepatitis A. The contagious liver virus can be transmitted through contaminated food and water and close contact with an infected person.

Patrons of the restaurant, located at 5389 Genesee St., and the nursing home, may have been exposed to the virus in late January, announced Erie County Executive Mark C. Poloncarz and Health Commissioner Gale R. Burstein. The food prep employee who worked there tested positive for the hepatitis A virus on Monday.

The county is offering an emergency vaccination clinic on from 3 to 8 p.m. Wednesday at Bowmansville Volunteer Fire Station No. 1, located at 36 Main St. in Bowmansville.

Restaurant patrons who could benefit from either a hepatitis A vaccine or immune globulin injection would have eaten at the restaurant between Jan. 27-30, county officials said. Those who patronized Al-E-Oops between Jan. 16-26 may have been exposed to the disease but would not benefit from an injection. Those who patronized the restaurant after Jan. 30 are at no risk.

Yesterday, the Salt Lake County Board of Health amended Health Regulation #5: Food Sanitation to require hepatitis A vaccination for all food workers in an establishment when anyone working in that establishment has been in contact with someone infected with hepatitis A. This amendment is in response to Salt Lake County’s ongoing hepatitis A outbreak and takes effect immediately, on February 1, 2018.

At least 181 people have been sickened in the Salt Lake area.

“Throughout this outbreak, we’ve identified that some people infected with hepatitis A share a household or are otherwise in contact with someone who works at a food service establishment,” explained Gary Edwards, SLCoHD executive director. “When we’ve learned this, we’ve immediately acted to vaccinate all food workers in that same establishment for the protection of the public. This amendment formalizes and codifies that health department response as it relates to food workers.”

The temporary amendment requires food service establishments to vaccinate all employees who handle food if any worker in the establishment is identified as a contact of someone confirmed to have hepatitis A. Establishments have 14 days to comply with the vaccine requirement; workers who do not comply within 14 days will be excluded from work assignments that involve handling food or food-contact surfaces.

Under the temporary amendment, food establishments are responsible for maintaining official record of their employees’ vaccination status. Each occurrence of an unvaccinated employee handling food or a food-contact surface will be recorded as a critical violation on the establishment’s inspection history, and repeated failure to comply may result in suspension or revocation of the affected food establishment’s permit to operate.

The temporary amendment also authorizes SLCoHD to reduce the cost of the first dose of the hepatitis A vaccine by up to 50 percent for anyone seeking vaccination at a health department immunization clinic who can document that they are a food-service employee in Salt Lake County.

Temporary amendments may be enacted by the Board of Health without the normal public hearing process in response to an imminent public health concern. Temporary amendments are limited to 120 days, during which the Board may, if they choose, engage in the full public notification and hearing process to permanently amend a regulation. The Board has not yet determined if it will be necessary to permanently amend Health Regulation #5.