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Home My WebLink About20130604_Multi-StateOutbreak of Hepatitis A (PDF)JEFFERSON COUNTY PUBLIC HEALTH 615 Sheridan Street  Port Townsend  Washington  98368 www.jeffersoncountypublichealth.org _____________________________________________________________________________________________ COMMUNITY HEALTH DEVELOPMENTAL DISABILITIES MAIN: (360) 385-9400 FAX: (360) 385-9401 ENVIRONMENTAL HEALTH WATER QUALITY MAIN: (360) 385-9444 FAX: (360) 379-4487 385 - - - 447 379 - - 940 385 - 9401 385 - - - Health Alert: Multistate Outbreak of Hepatitis A June 4, 2013 Dear Colleagues: This week a multistate outbreak of hepatitis A that may be linked to "Townsend Farms Organic Anti-Oxidant Blend", was announced. This product is a frozen berry and pomegranate seed mix. Costco has been contacting customers who purchased the product at their stores and according to Costco 23,000 units have been sold in the Northwest. You may also receive calls or see patients who are concerned about their possible exposure and requesting hepatitis A vaccine, or who have symptoms of acute hepatitis and may have consumed the product. The CDC has issued advice to consumers and retailers at: http://www.cdc.gov/hepatitis/Outbreaks/2013/A1b-03-31/advice-consumers.html which include recommendations to discard any product they may still have, and if product has been consumed within the past two weeks, hepatitis A vaccine is recommended, unless the person has previously been vaccinated for hepatitis A or had proven Hepatitis A disease. Patients are advised to seek medical attention for symptoms of hepatitis: jaundice, yellow eyes, abdominal pain, pale stools, or dark urine. So far 34 cases, including 11 hospitalizations, have been identified in 5 states (Colorado, New Mexico, Nevada, Arizona, and California, but the number of cases and affected states is expected to rise. Please report confirmed cases to us, and suspected cases with a history of exposure to "Townsend Farms Organic Anti-Oxidant Blend" within 2 weeks of onset of symptoms. Please call to report cases any time at 360 337-5235 Jefferson County Public Health (JCPH) has Hepatitis A vaccine available and a limited supply of immune globulin (IG). Please ask patients who have eaten this product and who are susceptible to Hepatitis A to call JCPH at 360-385-9400. Safeway Pharmacy may also be able to provide Hepatitis A vaccine, they do not administer IG. What are the current CDC guidelines for post exposure protection against Hepatitis A? Until recently, an injection of immune globulin (IG) was the only recommended way to protect people after they have been exposed to Hepatitis A virus. In June 2007, U.S. guidelines were revised to allow for Hepatitis A vaccine to be used after exposure to prevent infection in healthy persons aged 1–40 years. Persons who have recently been exposed to HAV and who have not been vaccinated previously should be administered a single dose of single-antigen Hepatitis A vaccine or IG (0.02 mL/kg) as soon as possible, within 2 weeks after exposure. The guidelines vary by age and health status: • For healthy persons aged 12 months–40 years, single-antigen Hepatitis A vaccine at the age- appropriate dose is preferred to IG because of vaccine’s advantages, including long-term protection and ease of administration, as well as the equivalent efficacy of vaccine to IG. COMMUNITY HEALTH DEVELOPMENTAL DISABILITIES MAIN: (360) 385-9400 FAX: (360) 385-9401 ENVIRONMENTAL HEALTH WATER QUALITY MAIN: (360) 385-9444 FAX: (360) 379-4487 385 - - - 447 379 - - 940 385 - 9401 385 - - 385 - - - 447 379 - - 940 385 - 9401 385 - - MAIN: (360) 385-9400 E FAX: (360) 385-9401 - ENVIRONMENTAL HEALTH WATER QUALITY MAIN: (360) 385-9444 FAX: (360) 379-4487 - • For persons aged >40 years, IG is preferred because of the absence of information regarding vaccine performance for post exposure prophylaxis in this age group and because of the more severe manifestations of Hepatitis A in older adults. Vaccine can be used if IG cannot be obtained. The magnitude of the risk of HAV transmission from the exposure should be considered in decisions to use vaccine or IG in this age group. For children aged <12 months, immunocompromised persons, persons with chronic liver disease, and persons who are allergic to the vaccine or a vaccine component, IG should be used. Please call 360-385-9400 to report cases and if you have additional questions. This message will be posted on our website www.jeffersoncountypublichealth.org. Sincerely, Scott Lindquist MD MPH Deputy Health Officer for Jefferson County 360-337-5237 (office)