San Diego Hep A Outbreak Expands

San Diego County health officials are advising anyone who may have eaten or had beverages at the World Famous restaurant in Pacific Beach, CA on specific dates, may have been exposed to the hepatitis A virus.

The dates and times of potential exposure at the World Famous restaurant, located at 711 Pacific Beach Drive in San Diego, are:

• Aug. 28, 29 and 30 between 3 p.m. and 11 p.m.
• Sept. 3 and 4 between 9 a.m. and 6 p.m.
• Sept. 10 and 11 from 3 p.m. to 11 p.m.

“The risk to the public is low, but anyone who ate or had beverages at the restaurant on those dates and times should be aware of the signs and symptoms of hepatitis A,” said Wilma Wooten, M.D., M.P.H., San Diego County public health officer.

“We encourage anyone who has not had the hepatitis A vaccine and may have been exposed, to contact their healthcare provider,” said Dr. Wooten.

On September 1, 2017, the San Diego County Public Health Officer declared a local public health emergency due to the ongoing hepatitis A virus outbreak in the county.

The outbreak of hepatitis A has killed at least 16 people in the area and at least 444 cases have been detected, leading to 305 people being hospitalized, as of 9/19/2017.

In 2014, a total of 1,239 cases of hepatitis A were reported from 50 states to CDC, a 30.4% decrease from 2013.

According to the Centers for Disease Control and Prevention (CDC), you should get hepatitis A vaccine if you:

• are traveling to countries where hepatitis A is common
• are a man who has sex with other men
• use illegal drugs
• have a chronic liver disease such as hepatitis B or hepatitis C
• are being treated with clotting-factor concentrates
• work with hepatitis A-infected animals or in a hepatitis A research laboratory
• expect to have close personal contact with an international adoptee from a country where hepatitis A is common

Someone with hepatitis can be contagious to others before they develop symptoms.  

The early signs and symptoms of hepatitis A appear two to seven weeks after exposure and commonly include mild fever, loss of appetite, nausea, vomiting, diarrhea, dark urine, light color stools, pain in the upper right abdomen, and yellowness to the eyes or skin (jaundice).

Anyone who has been immunized with the hepatitis A vaccine or previously had the disease, are considered protected from the virus.

Individuals can obtain hepatitis A immunizations through their primary care physicians and through many pharmacies.

Hepatitis A vaccine is an inactivated (killed) vaccine, according to the CDC.

You will need 2 doses for long-lasting protection. These doses should be given at least 6 months apart. Children are routinely vaccinated between their first and second birthdays (12 through 23 months of age).

Older children and adolescents can get the vaccine after 23 months. Adults who have not been vaccinated previously and want to be protected against hepatitis A can also get the vaccine.

There are three FDA approved monovalent hepatitis A vaccines:

• Vaqta (Merck) and Havrix (GlaxoSmithKline Beecham Biologicals), are approved for people ≥12 months of age in a 2-dose series
• A combined hepatitis A and hepatitis B Twinrix, (GlaxoSmithKline) vaccine is approved for people ≥18 years of age in the United States

The CDC Vaccine Price List provides current HAV vaccine contract prices and general information.

Vaccine discounts can be found at this webpage.

Previous research has found the costs related to treating a hepatitis A patient vary depending on their current or underlying condition.

This 2012 study found hepatitis A patients covered under commercial health insurance plans had "significantly higher" healthcare utilization and expenditures than non-infected patients. The average annual cost per Hep A patient was $11,479 versus $5,323 for a non Hep A patient.