Alabama Department of Public Health investigates Outbreak of Hepatitis A

The Alabama Department of Public Health is investigating an outbreak of hepatitis A. Since the beginning of September, 13 cases have been reported from scattered areas of the state.  The investigation is still in progress; however, it appears that most of these patients may have contracted the disease after eating raw oysters. Of the 11 patients who have been interviewed, 10 have eaten raw oysters in the period two to six weeks before getting sick. Most had eaten the raw oysters about a month before becoming ill.

"Even if these cases of hepatitis A were infected by eating raw oysters, this outbreak was not caused by Hurricane Katrina," said Dr. Donald Williamson, state health officer. "All of the persons had eaten the raw oysters before Katrina hit the coast." In fact, most of the individuals ate the raw oysters about two weeks before Katrina.

Preliminary information indicates that the 13 cases are scattered throughout the state as follows: seven from the Tuscaloosa area, two from the Birmingham area, two from the Montgomery area, one in Washington County, and one from Dallas County. At least five eating establishments may have been the source of contaminated oysters. Traceback activities will attempt to determine where the oysters were harvested.

The continuing investigation includes interviewing patients reported with hepatitis A, determining the dates and eating establishments where raw oysters were consumed or purchased, tracing back to find the source of the oysters, and collecting blood samples from patients that can be tested to see if all the patients were infected from the source. In addition, the close contacts of patients, especially those living in the same household, are given immune globulin to prevent hepatitis A.

Hepatitis A is a virus that affects the liver. It causes an illness that results in the patient turning yellow (jaundiced) because the liver is not working well. Other symptoms include fever, lack of energy and lack of appetite. Illness can last several weeks, but virtually every patient recovers.

Only humans can get infected with hepatitis A. The virus is in the patient's stool and is spread to others when infectious stool gets into someone else's mouth. For example, the virus can be transmitted from contaminated food and water or directly, as among children in child care centers. After ingesting the hepatitis A virus, it takes two to six weeks before the person becomes ill.

There have been 19 cases of hepatitis A reported in Alabama from January through August of this year. Last year there were 10 cases. In 2003 there were 24 cases. Among these cases, only one patient gave a history of eating raw shellfish in the two to six weeks before becoming ill.

Source: Alabama Department of Health