Hepatitis A Exposure Update: DPH Announces Potential Exposure at Two Additional Food Establishments, Updated Timeline

DOVER – The Division of Public Health (DPH) is providing updated information regarding a potential Hepatitis A exposure at a Buffalo Wild Wings food establishment in Middletown, which was announced on Thursday, April 11, 2019. New information indicates that potential exposures began earlier at the Middletown restaurant than previously reported, therefore the time frame for which DPH is providing guidance to restaurant staff and diners has been updated. As part of its ongoing investigation, DPH has also determined that exposure to the Hepatitis A virus may have also occurred at a second Buffalo Wild Wings location in Bear, as well as the Stone Balloon Ale House in Newark.

DPH is taking steps to protect anyone who might have been exposed to the virus. Staff who worked at these food establishments during the indicated timeframes should contact their health care provider to receive post-exposure prophylaxis (PEP), which may include the hepatitis A vaccine or a shot of immune globulin to prevent severe illness.

· Stone Balloon, 115 E. Main St., Newark – Potential exposures began on March 20, 2019 and ended with a cleaning of the facility on April 3, 2019. The timing of the cleaning at this facility was not related to the potential exposures, but would have ended the exposure window.

· Buffalo Wild Wings, 1887 Pulaski Highway, Bear – Potential exposures began on March 21, 2019 and ended with the voluntary closure and cleaning of the facility on April 12, 2019.

· Buffalo Wild Wings, 540 W. Main St., Middletown – New information indicates that potential exposures began earlier than previously reported. Potential exposures began on March 28, 2019 and ended with the voluntary closure and cleaning on April 10, 2019.

Diners who ate at these food establishments during the indicated timeframes, and who fall into a high-risk category should contact their primary health care provider for further risk assessment and guidance. Though the risk of diners contracting Hepatitis A after dining at the establishments is low, post-exposure treatment may be considered for high-risk individuals in these categories:

· People with chronic liver disease, including cirrhosis, Hepatitis B, or Hepatitis C
· People who are immunocompromised
· Women who are pregnant
· Anyone with jaundice or symptoms compatible with Hepatitis A
· People who use drugs (injection or non-injection)
· People experiencing homelessness
· Men who have sex with men (MSM)
· People who are, or were recently, incarcerated

“We understand that this information may be concerning to individuals who dined or worked at any of the restaurants during this timeframe,” said DPH Medical Director Dr. Rick Hong. “However, we want to stress that the risk of transmission of the virus to those who dined at these restaurant locations is low. Because DPH’s mission is to protect and promote the health of all people in Delaware, we are recommending those who visited these restaurants during the exposure timeframe, contact their health care provider to discuss their individual risk factors.” DPH’s Office of Food Protection and Office of Infectious Disease Epidemiology continues to work with restaurant management on the investigation to ensure staff at these locations are aware of the recommendations to receive PEP.

Those with health insurance who have concerns, need a risk assessment, and do not have a primary health care provider should visit a local walk-in medical center (not an emergency room) or call the DPH Office of Infectious Disease Epidemiology at 302-744-4990 or 1-888-295-5156.

If a restaurant staff member or a high-risk individual who dined at the one of the food establishments needs vaccine and is uninsured or underinsured, they should contact one of the following DPH health clinics Monday through Friday at:

· Porter State Service Center, 509 W. 8th St., Wilmington, DE 19801 302-777-2860
· Hudson State Service Center, 501 Ogletown Road, Newark, DE 19711 302-283-7587, option 2
· Kent County Health Unit, River Road, Dover, DE 19901, 302-857-5140
· Sussex County Health Unit, 544. S. Bedford St., Georgetown, DE 19947, 302-515-3220

Hepatitis A is a viral infection of the liver and usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person. The virus can spread when an infected person does not wash his/her hands adequately after using the toilet, prepares food or shares utensils with others while eating, or engages in other behaviors that increase risk of infection. Symptoms may include:

· Loss of appetite
· Nausea
· Tiredness
· Fever
· Stomach pain
· Brown-colored urine and light-colored stools
· Yellowing of the skin of eyes

Symptoms can appear up to 15 to 50 days after exposure to the virus. If anyone develops these symptoms, they should stay at home and contact their health care provider immediately. There is no specific treatment for Hepatitis A infection aside from rest, fluids, and good nutrition. Those with Hepatitis A should avoid drugs and alcohol.

Careful hand washing, including under the fingernails, with soap and water, is an important tool to prevent the spread of this disease.

For more information about Hepatitis A, visit www.cdc.gov/hepatitis, https://www.dhss.delaware.gov/dhss/dph/dpc/hepa.html or call the DPH Office of Infectious Disease Epidemiology at 302-744-4990 or 1-888-295-5156.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

The Delaware Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.