CDC HEALTH UPDATE
OCTOBER 1, 2003

CDC Update: Hepatitis A Outbreaks in Tennessee and Georgia

On September 18, the Knox County (Tennessee) Health Department (KCHD) reported that four cases of hepatitis A had occurred in food handlers employed at the O’Charley’s Restaurant. At this time there are at least 57 cases of hepatitis A associated with a single O'Charley's Restaurant in Knoxville, Tennessee, including seven food handlers whose onset of illness coincided with those of patrons. However, no food handler has been identified as a potential source of transmission. Most cases identified to date have onset dates clustered around early to mid-September 2003. An investigation to determine the source of the outbreak is underway. On September 29, the Centers for Disease Control and Prevention (CDC) sent two epidemiologists to Knoxville to assist the Tennessee East Regional Health Office and Knox County health officials in the investigation.

The Georgia Division of Public Health is investigating a hepatitis A outbreak among residents of Middle and North Georgia. Since September 1, 2003, Georgia has received reports of more than 130 cases of hepatitis A from across the state. An investigation is underway in Georgia, which includes laboratory testing by the CDC. No source of Georgia's outbreak has yet been identified, but the Georgia Division of Public Health has indicated that it can not be attributed to eating at any single restaurant chain.

Persons with hepatitis A should be reported immediately to state or local health departments. If persons with both hepatitis A and a history of travel to either of these two states during the incubation period (2-6 weeks) are identified, please alert the Tennessee (615-741-7247) or Georgia (404-657-2588) health departments. In all states, clusters of persons with hepatitis A, or persons with hepatitis A but without typical risk factors for the illness, should be queried about restaurants patronized during the incubation period. CDC should be contacted if common restaurant exposures are identified (Division of Viral Hepatitis, 404-371-5910). Available serum from these cases should be frozen and saved for possible further testing at CDC.

Categories of CDC Health Alert messages:
Health Alert: conveys the highest level of importance; warrants immediate action or attention.
Health Advisory: provides important information for a specific incident or situation; may not require immediate action.
Health Update: provides updated information regarding an incident or situation; unlikely to require immediate action.

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