Nobody wants Hepatitis A. Seriously. You don’t want it. Your patients don’t want it. Your mom doesn’t want it. It’s not good.
But we all want that sushi.
And that might be a problem.
Think back over the past two weeks. Have any of your patients displayed symptoms of hepatitis A after eating raw or undercooked tuna? If you answered yes, it’s possible that their tuna roll was contaminated with the hepatitis A virus.
You see, in mid-May, Hawaii-based Hilo Fish Co. began recalling tuna products that had tested positive for hepatitis A. Some of that tuna was distributed to restaurants and stores throughout Texas as well as Oklahoma and California.
Therefore, you should consider a hepatitis A diagnosis if any of your patients display even some of the symptoms of the disease. Symptoms include fever, headache, malaise (malaise!), and vomiting along with jaundice or elevated serum alanine aminotransferase or aspartate aminotransferase levels.
Furthermore, it’s a good idea to check the immunization status of all your patients and offer the vaccine to anyone who is not up to date. The Centers for Disease Control and Prevention (that’s the CDC to you and me) also advises postexposure prophylaxis for unvaccinated people whose exposure occurred in the past two weeks.
It’s all part of an effort by state health officials to monitor and prevent spread of the disease.
As of June 1, no cases have been linked to tuna consumption, according to the Texas Health and Human Services Commission.
If you need a refresher course, hepatitis A is a contagious liver disease that is a result of exposure to the virus, which can happen by ingesting contaminated food or water, or via unvaccinated family members, sexual partners, or close contacts. (This paragraph doesn’t count as CME, by the way.)
A lot more information can be found at the HHS’s website, including laboratory confirmation testing, managing close contacts, and infection control. You can also find out more on the U.S. Food and Drug Administration website.
And just so you know, in Texas, you are required to report a diagnosis or even a suspicion of hepatitis A within one workday. “Do not wait for laboratory confirmation to report suspect hepatitis A cases,” HHS said in a statement. Hepatitis A reports should be sent to your local health department or by calling (800) 705-8868.
Action, June 15, 2017