Hepatitis A Outbreak Linked to Virginia Restaurant Chain Sickens 50 People, Kills One

Hepatitis A Outbreak Linked to Virginia Restaurant Chain Sickens 50 People, Kills One
A medical illustration of the hepatitis A virus (Photo: CDC)

An outbreak of hepatitis A has sickened at least 50 people in Virginia, with one person dying and another needing a liver transplant. The cases have been tied to a restaurant employee who worked at several locations of a local chain. Though the spread of the outbreak is now thought to be largely contained, more cases may show up, health officials have cautioned.

The first reports of the outbreak emerged in late September, when officials with the Roanoke City and Alleghany Health Districts announced that 10 people had been sickened with the viral illness. These cases were all traced back to a restaurant chain known as Famous Anthony’s. Their investigation eventually identified the likely source: an employee who had worked recently at three different locations where cases had been found and had tested positive for the virus.

About two weeks ago, officials announced the first death in connection to the outbreak, a 75-year-old man with underlying health conditions who had frequently visited the restaurant. Another victim was reported to have needed a liver transplant. And this week, health officials confirmed to local media outlets that 50 cases have been found so far, with 31 people ending up in the hospital as a result.

Hepatitis is what doctors call liver inflammation, with certain viruses being the most common cause. Despite the branding, none of the five main sources of viral hepatitis (A through E) are related to one another, but they do tend to cause similar acute symptoms. These include fever, headache, nausea, abdominal pain, discolored urine, and jaundice. Hepatitis B and C can turn into chronic infections that lead to long-term liver damage, but A and E usually cause self-limiting, if very unpleasant, bouts of illness (hepatitis D is weird even among viruses, since it only can survive as a co-infection with hepatitis B). Like B and C, hepatitis A can be spread through contact with bodily fluids, but it’s also a foodborne infection.

The original infection occurred in August, with subsequent victims being exposed through August 27. Because the virus has an incubation period of up to 50 days, and no further cases have been identified as of October 15, officials say they’re confident that the chain of transmission has ended. But since a minority of people can remain symptomatic up to six months later, it’s possible that more cases tied to the original outbreak will be reported in the future. It’s also possible that more secondary infections will be found. Forty-nine of the 50 cases have been traced back to Famous Anthony’s, but one case was likely caught from a person sickened at the restaurant.

For some but not all Americans, hepatitis A isn’t a concern, since there’s been a childhood vaccine available for it since the 1990s. It’s recommended that every person get vaccinated starting at age one, and protection has been shown to last at least 20 years and may be lifelong. But it’s only mandated for school kids in about half the country. Restaurant workers, who may come from countries where vaccination isn’t available, may also be uniquely vulnerable to outbreaks. Incidentally, cases of hepatitis A in the U.S. have been on the rise in recent years, thanks to large-scale outbreaks.

In response to this outbreak, Virginia health officials have been holding vaccination clinics. Even after exposure, the vaccine can prevent illness if administered soon enough.