A foodservice worker in Hawaii may have exposed customers of a Honolulu restaurant to the hepatitis A virus during a five-week period ending Jan. 6. Health officials say the case is likely not related to a multi-state outbreak that has sickened 1,500 and killed almost 50.

Most of the customers of the Wah Kung Restaurant are past the window of opportunity for post-exposure treatment, which must be given within two weeks to effectively prevent infection. However, diners who ate or drank at the restaurant on Jan. 5 and 6 have a couple of days left to seek the post-exposure vaccine.

“Given the clinical and laboratory findings, we suspect this individual may be infected with hepatitis A,” State Epidemiologist Sarah Park said Thursday in a news release.

“Because of the limited two-week window to prevent infection among those potentially exposed, we are alerting the public as a precaution. We encourage people to take appropriate action to protect their health and prevent possible new cases in our community.”

State officials had not confirmed any hepatitis A infections among customers of the Wah Kung Restaurant as of the posting of the news release.

Anyone who ate or drank at the restaurant from Dec. 1, 2017, through Jan. 6 should monitor themselves for symptoms of hepatitis A infection in the coming weeks, according to the Hawaii Department of Health’s consumer advice.

It can take as many as 50 days after exposure to the virus for symptoms of infection to develop, and people can spread the virus before symptoms begin. Some people who are infected never develop any symptoms, complicating the impact of the highly contagious pathogen.

Symptoms can include fever, fatigue, loss of appetite, abdominal discomfort, dark urine, diarrhea and yellowing of the skin or eyes.

Most adults in the United States have not been vaccinated for hepatitis A. It can cause relatively mild infections in healthy young adults. Older people, anyone with a compromised immune system and pregnant women are at a high risk of developing serious and sometimes fatal infections from the virus.

The virus is found in the feces of people infected with hepatitis A and is usually spread in microscopic amounts through close personal, sexual contact, or consuming contaminated food or beverages. Public health officials say one of the best ways to prevent the spread of the virus is frequent and thorough hand washing.

Hawaii officials announced on Jan. 5 that two residents of the islands had been confirmed with the outbreak strain of hepatitis A that began in San Diego in 2016 and is ongoing. The strain has spread to numerous states, hitting homeless people and substance abusers particularly hard.

However, a quarter to a third of the more than 1,500 confirmed cases have been people who were neither homeless nor substance abusers.

An increasing number of restaurant workers in the outbreak states are testing positive for the virus, resulting in tens of thousands of people seeking post-exposure vaccination.

In Hawaii, public health officials have created an online tool to help the public locate vaccinating pharmacies and clinics at http://health.hawaii.gov/docd/vaccines-immunizations/vaccine-locators/.

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