What you should know about Utah’s hepatitis A outbreak and recent restaurant exposures

(Rick Egan | Tribune file photo) 7-11

So you downed a hot dog from a West Jordan 7-Eleven recently, or devoured a plate of the Spanish Fork Olive Garden’s pasta.

Both are the type of ho-hum meal you might never think about again — but these could’ve contained traces of hepatitis A-infected feces.

Thousands of Utahns had that rude awakening this week, when health officials in Salt Lake and Utah counties blasted out alerts saying employees infected with the viral disease had worked for several days at a trio of food establishments. The cases grabbed national headlines, and prompted hundreds of nervous customers to call into health hotlines to inquire about vaccine options.

It’s not yet clear if additional people have been infected from the exposures at a 7-Eleven in West Jordan and Olive Garden and Sonic Drive-In restaurants in Spanish Fork. But the largest hepatitis A outbreak Utah has seen in years is already here, having sickened more than 130 homeless people in recent months.

Health officials’ biggest fear is that the hepatitis outbreak among the homeless might leap into the general population — and these latest exposures at area eateries have raised that dire possibility.

What’s hepatitis A? How do I know if I have it?

It’s a highly contagious liver infection that usually spreads when infected feces reach the mouth via contaminated food, water or dirty hands. Most people recover within a few weeks. But sometimes, the disease can cause significant liver inflammation, and occasionally leads to death.

Symptoms include nausea and vomiting; abdominal pain; fever; diarrhea; and jaundice, or the yellowing of the skin and whites of the eyes. People with underlying medical conditions — often including homeless people and drug addicts — are more likely to face worsened symptoms and require hospitalization.

Hepatitis B and C can cause similar symptoms, but they spread differently — and both can have lasting impacts on the liver, where healthy people with hepatitis A typically recover fully without treatment.

In a normal year, Utah sees fewer than five hepatitis A cases.

How did the outbreak begin in Utah?

The first outbreak-related case came from California and surfaced here in May, state health officials have said. The next case didn’t arise for another month, due to the disease’s slow incubation period, usually about two to six weeks.

State and county health agencies began actively combating an outbreak in August, offering vaccines in areas where homeless congregate and reaching out to restaurants to remind them the disease was present.

Will it continue to spread?

The number of Utahns infected has grown from a handful in late summer to at least 133 in early January, according to state figures. Before the West Jordan and Spanish Fork exposures, however, the disease had been relatively confined, and health officials said they hoped it might be largely snuffed out by March, after an aggressive vaccination campaign through the winter.

But the recent exposures could trigger a rapid spread of hepatitis A into the general population. State public health experts have reason to worry: Restaurants have been the source of massive hepatitis outbreaks before, including a 2003 Pennsylvania episode where more than 500 people were sickened and several died. In Salt Lake City, a Taco Bell worker infected at least 21 people in 1995.

Though usually two to four weeks, the incubation period for hepatitis A can be as long as seven weeks, so officials may not know for several days whether anyone who visited the eateries has been sickened.

Should you get vaccinated?

Yes — especially if you visited the West Jordan 7-Eleven, 2666 W. 7800 South between Dec. 26 and Jan. 3. Or, if you visited the Spanish Fork Olive Garden, 1092 N. Canyon Creek Parkway between Dec. 21 and 30, or the Sonic Drive-In, 971 N. Main, on Dec. 23 or 24.

Those in Salt Lake County should call a hotline, 385-468-INFO (4636) for vaccine options. Utah County residents are asked to call 801-851-HEPA (4372) for vaccine information. The Utah Department of Health also set up an online questionnaire to gauge risk of exposure, at health.utah.gov/investigation.

Many people have already been vaccinated for hepatitis A at some point in life.

“It’s wise for anyone to look into their vaccination records,” said Aislynn Tolman-Hill, a spokeswoman for the Utah County Health Department. And if they haven’t received a vaccination — even if they haven’t visited the three restaurants — they should seek one out, she said.

Tolman-Hill said the department’s hotline, staffed with 10 people, was swamped Wednesday morning after sending out the alert Tuesday night.

The same situation played out at the Salt Lake County Health Department, where more than 750 people called in through Tuesday after officials sent out an alert Sunday evening. About 500 people in Salt Lake County were referred for vaccines, spokesman Nicholas Rupp said.

Are other states facing hepatitis outbreaks?

Utah is one of three major hepatitis A outbreaks in the country, but the other two — in California and Michigan — are much larger and more deadly. The two states combined have dealt with more than 1,300 cases last year, including about 1,000 hospitalizations and 43 deaths, according to the federal Centers for Disease Control and Prevention.

Like Utah, both states saw most of their cases in their homeless populations. But both California and Michigan also have had restaurant-related scares tied to the outbreaks, according to news reports.

Twitter: @lramseth

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