May 26, 2023
Action Requested
- Be aware that a hepatitis A case occurred in a food worker who worked at two Taco Bell locations: 2727 Broadway in Everett and 303 91st Ave NE in Lake Stevens.
- There may be public exposures of customers who ate food from the Everett location on May 22 or 23, or from the Lake Stevens location on May 23.
- No further action is required for a patient who worked at or ate at those locations on the dates listed above if they are immune due to vaccination against hepatitis A or prior hepatitis A infection. Patients may contact their medical provider with requests to confirm their immunization status if they were potentially exposed to this case.
- If someone is not immune due to vaccination or prior infection, or if their immunization status is uncertain, they should be provided with post-exposure prophylaxis within 14 days of exposure to protect against illness.
- Hepatitis A vaccine should be administered as soon as possible, within 2 weeks of exposure, to all unvaccinated people aged ≥12 months who have recently been exposed to hepatitis A virus (HAV). In addition to hepatitis A vaccine, co-administration of GamaSTAN S/D immune globulin (0.1 mL/kg) is recommended under certain circumstances according to age and health status of the exposed person.
- Hepatitis A vaccine is available from multiple healthcare providers or pharmacies in the county. Anyone who was exposed and is having trouble finding a vaccine provider, or who is uninsured or underinsured, should contact the Health Department at 425-339-3503 (then press 1).
- Patients potentially exposed to this case also should be instructed to take the following precautions:
- Monitor for any symptoms of illness. Stay home and do not prepare or serve food for others if you have symptoms. It takes between 15 and 50 days to become symptomatic after being exposed. Early signs of hepatitis A include:
- fever
- fatigue
- loss of appetite
- nausea
- vomiting
- diarrhea
- dark urine and jaundice (yellowing of eyes or skin)
- If they develop any of these symptoms, be especially thorough in handwashing after using the restroom and before preparing or handling food to avoid potentially spreading the illness further. Wash hands with soap and running water. Be sure to lather and scrub all surfaces including backs of the hands, wrists, between fingers, and under fingernails.
- Report cases of acute hepatitis A in Snohomish County patients to the Snohomish County Health Department within 24 hours.
Background
The Snohomish County Health Department has identified a case of hepatitis A that occurred in a food worker who worked at two Taco Bell locations: 2727 Broadway in Everett and 303 91st Ave NE in Lake Stevens. Potential exposures at the Everett location were May 22-23, and potential exposures at the Lake Stevens location were May 23. Public notice has been provided via a news release and public postings at the businesses.
The confirmed case appears to have been infected during international travel. The Health Department is working with the business to identify other workers who were potentially exposed and connect them with prevention information as well as resources for vaccination and post-exposure prophylaxis, as needed.
The hepatitis A virus typically spreads through fecal contamination. The illness varies in severity, with mild cases lasting two weeks or less. More severe cases can last six weeks or longer. Some individuals, especially children, may not develop jaundice and may have an illness so mild that it can go unnoticed. However, even mildly ill people can still be highly infectious.
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