Updated Information: DPH Announces Potential Exposure at Two Additional Food Establishments and Updated Timeline

DOVER – The Division of Public Health (DPH) announced today that employees and patrons of Buffalo Wild Wings located at 540 W. Main St., Middletown, may have been exposed to the hepatitis A virus between March 31 and April 10, 2019. When notified yesterday about the possible exposures, the establishment voluntarily closed for cleaning and sanitization prior to reopening to the public on April 11.

While it is relatively rare for restaurant patrons to become infected with hepatitis A virus from a food establishment due to standard sanitation practices, DPH is taking steps to protect anyone who might have been exposed to the virus. Anyone who consumed food or drink at this restaurant between March 31 and April 10 should consider contacting their health care provider for further guidance regarding the potential exposure, especially those with symptoms, with chronic medical conditions or women who may be pregnant.

Staff of the food establishment 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.

Those who do not have a primary health care provider should visit a local walk-in medical center (not an emergency room), and those who are uninsured or underinsured should contact one of the following DPH health clinics 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. Generally, rest, fluids, and good nutrition are all that is needed. 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.

The Delaware Division of Public Health (DPH) is advising Delawareans of a multistate outbreak of E. coli infections linked to chopped romaine lettuce from the Yuma, Arizona, growing region. The lettuce could be contaminated with Shiga toxin-producing Escherichia coli O157:H7 and could make people sick. To date, there have been no confirmed cases reported in Delaware, but DPH urges consumers to take precautions to prevent illness.

Consumers who have store-bought chopped romaine lettuce at home, including salads and salad mixes containing chopped romaine lettuce, should not eat it and instead throw it away, even if some of it was eaten and no one has gotten sick. If you do not know if the lettuce is romaine, do not eat it and throw it away. Before purchasing romaine lettuce at a grocery store or eating it at a restaurant, consumers should confirm with the store or restaurant that it is not chopped romaine lettuce from the Yuma, Arizona, growing region. Do not buy or eat it if the source of the romaine lettuce is unknown.

Restaurants and retailers should not serve or sell any chopped romaine lettuce, including salads and salad mixes containing chopped romaine lettuce, from the Yuma, Arizona, growing region. Businesses should ask their suppliers about the source of their chopped romaine lettuce.

The Centers For Disease Control and Prevention (CDC), U.S. Food and Drug Administration (FDA), and multiple states are investigating the outbreak. According to the CDC, no common grower, supplier, distributor, or brand has been identified at this time.

• 35 people infected with the outbreak strain of E. coli O157:H7 have been reported from 11 states. According to the CDC, nearby Pennsylvania has reported nine cases, New Jersey has reported seven cases, and Virginia has reported one case.

• 22 ill people have been hospitalized, and three people have developed kidney failure. No deaths have been reported.

People usually get sick from Shiga toxin-producing E. coli two to eight days (average of three to four days) after swallowing the bacteria. Most people infected with E. coli O157 develop diarrhea, severe stomach cramps and vomiting. Most people recover within one week. Some illnesses last longer and can be more severe, resulting in a type of kidney failure called hemolytic uremic syndrome (HUS). HUS can occur in people of any age but is most common in young children under 5 years, older adults, and people with weakened immune systems.

Symptoms of HUS can include fever, abdominal pain, pale skin tone, fatigue and irritability, small, unexplained bruises or bleeding from the nose and mouth, and decreased urination. People who experience these symptoms should seek emergency medical care immediately. Medical providers should report suspected cases of E. coli O157:H7 to the DPH Office of Infectious Disease Epidemiology at 302-744-4990 or 24/7 at 888-295-5156.

For more information:

CDC: Multistate Outbreak of E. coli O157:H7 Infections Linked to Chopped Romaine Lettuce

CDC: Multistate Outbreak of E. coli O157:H7 Infections Linked to Chopped Romaine Lettuce (Espanol)

Advice to Consumers, Restaurants, and Retailers 

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.

Delaware 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.

Free flu shots from Division of Public Health on October 10 in Dover

DOVER, Del. – Governor John Carney will attend the Division of Public Health’s (DPH) drive-thru flu vaccination clinic on Tuesday, October 10, and receive his flu shot following an 11:00 a.m. press conference at the DelDOT Administration Building, 800 S. Bay Road in Dover.

DPH, in partnership with Bayhealth, will administer free flu shots at the drive-thru clinic from 6:00 a.m. to 6:00 p.m. to drivers and pedestrians.  Anyone age 9 and up is welcome. Any size vehicles and any number of people in one vehicle are welcome.

Flu shots protect the individual as well as his or her family, friends, and co-workers. During the 2016-2017 flu season, there were more than 4,500 flu cases reported in Delaware and 15 flu-related deaths.

For fastest service, complete the Influenza Vaccination Administration Record (VAR) form and bring one form per person to the drive-thru clinic.  Greeters will also have VAR forms on hand.

DPH asks attendees to wear short sleeves or loose fitting clothing for access to the upper arm.  American Sign Language interpreters and staff speaking Spanish and Haitian Creole will be on site.

View the flu clinic schedule at flu.delaware.gov or call DPH at 1-800-282-8672.  To find flu clinics in your ZIP code, visit www.flu.gov

WHAT:          Governor John Carney will receive his flu shot at the 11:00 a.m. press conference during the Division of Public Health’s Drive-Thru Flu Clinic.

WHO:             Governor Carney

Dr. Kara Odom Walker, Secretary, Delaware Department of Health and Social Services (DHSS)

Nicole Majeski, Deputy Secretary, Delaware Department of Transportation (DelDOT)

Dr. Karyl Rattay, Director, Division of Public Health (DPH), DHSS

WHEN:          Tuesday, October 10, 2017 – rain or shine

11:00 a.m. to 12:00 p.m., Press conference

6:00 a.m. to 6:00 p.m., Flu clinic

WHERE:       DelDOT Administration Building – front parking lot

800 S. Bay Road

Dover, DE 19901

In case of rain, the press conference will be held indoors.

PHOTOS:      Officials speaking and getting their flu shots, Delawareans lined up in their cars for intramuscular flu vaccine administered by DPH and Bayhealth nurses, and close-ups of flu vaccine. Clients who sign media consent forms may be photographed. Live broadcasts by Eagle 97.7 from 7:00 a.m. to 9:00 a.m. and Cool 101.3 from 3:00 p.m. to 5:00 p.m.

DOVER – On behalf of Delawareans and public health, DNREC has taken two recent actions through the federal court system and US Environmental Protection Agency  aimed at requiring “upwind states” to reduce air pollution generated within their borders that carries into and pollutes Delaware’s air, causing asthma, respiratory disease, and other public health problems for Delawareans.

The first action – a petition filed in U.S. Court of Appeals for the District of Columbia Circuit challenges an EPA final rule that granted a one-year extension to the Philadelphia-based ozone nonattainment area to comply with the 2008 national ozone standard. This area includes Delaware, Pennsylvania, Maryland and New Jersey. Delaware believes EPA should require pollution reduction programs to address the transport of emissions from one state to another, rather than granting the extension. Pennsylvania, Maryland and New Jersey requested the extension of the attainment deadline, but Delaware argued against it based on its analysis that meteorological conditions were more responsible for temporary improved air quality readings in the nonattainment zone, rather than actual reductions in air pollution.

“Delaware residents, businesses and industry have made great strides in reducing our own sources of air pollution’” said DNREC Secretary David Small. “But we cannot meet our air quality standards without sources in other states taking similar action. We are still dramatically affected by what upwind states are doing – or not doing – toward meeting air quality standards. If we are going to continue to ask Delawareans to do more, we need EPA to take steps to level the playing field between states. This action is the latest in a number that the Department has taken to seek EPA’s help.”

Delaware has complied with the requirements of the federal Clean Air Act by adopting in-state control measures for the prevention of emissions that would significantly contribute to non-attainment of the 8-hour ozone standard established by EPA. These actions have not only helped improve air quality in Delaware but have helped reduce impacts to our neighboring states that can be affected by the transport of air and contaminants. However, Delaware’s ability to achieve and maintain health-based air quality standards is severely impeded because more than 94 percent of bad ozone levels in Delaware are created by the transport of air pollutants from upwind states. DNREC’s Division of Air Quality has determined that attainment of the 8-hour ozone standards in Delaware is possible only through additional emission reductions in these upwind states that include  Maryland and Pennsylvania and other states further west and as far away as Michigan, Indiana, Ohio and Kentucky..

Predictably, the return of typical summer weather conditions of hot, humid sunny days has led to ozone exceedances in the Mid-Atlantic region, and air monitors throughout the Philadelphia non-attainment area, including Delaware, have confirmed that  air remains unhealthy by recording multiple exceedances of the ozone standard, with more exceedances likely to come over the next couple of months.

The second action taken this week by DNREC and Delaware is aimed specifically at the Brunner Island Power plant near York, Pa. Delaware filed a petition with the EPA under Section 126 of the Clean Air Act asking EPA to make a finding that emissions from the Brunner Island plant, with its three coal-fired electric generating units, significantly contributes to unhealthy ozone concentrations in Delaware.

Delaware’s petition is based on computer modeling that demonstrates that emissions from Brunner Island’s coal-fired units contribute heavily to ozone levels in Delaware that exceed the 2008 and 2015 8-hour ozone standards. EPA’s granting of the petition would require the Brunner Island facility to promptly reduce the emissions that significantly contribute to ozone exceedances in Delaware.

Brunner Island’s three coal-fired electric generating units are not currently equipped with modern nitrogen oxide (NOx) controls similar to those installed starting in 2010 at Delaware’s NRG Indian River facility near Millsboro – which have reduced the annual NOx emissions rate by upwards of 80 percent from the last remaining coal-fired electric generating unit at that facility, according to DNREC statistics. Modern NOx controls, such as selective catalytic reduction (SCR), have been in commercial service at coal-fired electric generating units for decades, and have the ability to significantly reduce NOx emissions from coal-fired combustion sources.

NOx is a precursor pollutant to the formation of ambient ozone. Ozone is formed when chemicals in the air such as NOx and volatile organic compounds react together in hot sunny conditions. Under Section 126 of the Clean Air Act, the EPA must make the requested finding or deny DNREC’s petition within 60 days after receipt.

Background on ozone The EPA established a short-term ozone standard (8-hour National Ambient Air Quality Standard) to address the potential health impact of short-term exposure to high levels of ozone. Short term exposure to ozone can cause rapid, shallow breathing and related airway irritation, coughing, wheezing, shortness of breath, and exacerbation of asthma, particularly in sensitive individuals and asthmatic children. Short term exposure to ozone also suppresses the immune system, decreasing the effectiveness of bodily defenses against bacterial infections. Research studies indicate that markers of cell damage increase with ozone exposure. Some studies suggest that there is a link between ozone exposure and premature death of adults and infant death. Other studies indicate a link between ozone and premature birth and adverse birth outcome, cardiovascular defects, and adverse changes in lung structure development in children. Children, the elderly, those with chronic lung disease, and asthmatics are especially susceptible to the pulmonary effects of ozone exposure. Additionally, studies have shown that ozone can adversely affects trees and vegetation, can cause reduced crop yields, and can contribute to the “nitrification” of bodies of water.

The formation of atmospheric ozone is a particular problem in the eastern United States and to Delaware because of its strategic Mid-Atlantic location during warm summer months when atmospheric conditions are the most conducive to ozone formation. The summer months also tend to coincide with periods of high electric consumption and the required electric generation to meet the electric demand. High levels of NOx emissions associated with the generation of electricity using fossil fuels contribute to the formation of ozone. In fact, the annual period comprising May 1 through September 30 is referred to as the “ozone season.”

CONTACT: Michael Globetti, DNREC Public Affairs, 302-739-9902

Vol. 46, No. 250