Health Department Doctor Downplays Beer Garden Contagion, But Hepatitis A Cases 'Quite Unusual'

Sep 26, 2018

The Health Department continues to track cases of hepatitis A that have been occuring since February.

The incidents have forced some affected customers to get vaccinations after possible exposure.

But the Arkansas Department of Health's recent investigation into the cause of some 175 sick customers at JJ's Beer Garden and Brewing Co in Fayetteville doesn't appear to be related to the outbreaks of hepatitis A in the eastern part of the state.  That case was instead found to be related to norovirus. 

Arkansas Public Media spoke with state epidemiologist Dr. Dirk Haselow, who's tracking the ongoing hepatitis A cases.

State Epidemiologist Dr. Dirk Haselow
Credit Daniel Breen / ARKANSAS PUBLIC MEDIA

DR. DIRK HASELOW: In terms of having multiple clusters of illness in the state at any one time, in reality we have that often.  We, being a single centralized health department, learn of clusters of illness in the entire state and monitor the health and safety of Arkansans year-round, and it's not uncommon for us to have two or three clusters of something going on at any one time.  I'll admit that the hepatitis A cluster is quite large and quite unusual. But if the Beer Garden outbreak turns out to be norovirus, we have clusters of norovirus every year in a variety of settings and that would not be highly unusual.

ANN KENDA: The health department issued advisories this spring and summer about possible hepatitis A exposures at various fast food restaurants, mostly concentrated in the northeast. What was the department's response? 

HASELOW: Even though we did have some food worker exposures, we implemented some vaccination clinics to make sure that customers could mitigate risk if they went there and ate.  We do not believe that's the reason why this outbreak is going on. We are seeing this outbreak in high-risk populations — individuals who are homeless or have transitional housing, individuals who may or may not use drugs, individuals who engage in high-risk sexual behaviors, and other risk factors as well.  It turns out that hepatitis A, while classically is foodborne, can be transmitted a variety of different ways because it's such a hearty virus. It can live for a month on a hard surface, and it's even somewhat resistant to being killed by hand sanitizers.

A map of Hepatitis A outbreaks across Arkansas.
Credit Arkansas Department of Health

KENDA:  The Health Department offered vaccination clinics, to spare patients from the weeks of illness that can accompany hepatitis A exposure.  It’s not usually a matter of life and death.

HASELOW: Generally speaking, people with hepatitis A get over it. The younger you are, the milder course of infection you tend to have.  The older you are, the worse it is.  In our outbreak, over half of the individuals who have tested postive have been hospitalized for days, predominantly for nausea and vomiting and dehydration and abdominal pain.  And we have had one death.  But generally speaking, hepatatis A is not assocaited with bad outcomes.  Very rarely do people die from hepatitis A if they are otherwise normal, healthy people.

KENDA: The majority of cases may not have been connected to restaurants but you say restaurants would be well-advised to take preventative measures to help end this outbreak?

The Health Department offered vaccinations to customers of the Pizza Inn on Southwest Drive in Jonesboro who ate there Sept 13 - 24.
Credit Ann Kenda / ARKANSAS PUBLIC MEDIA

DR. HASELOW: I think a lot of restaurants are paying close attention to this. The consequence of having a hepatitis A case in a restaurant can be dire for the restaurant's businsess.  Many restaurants have chosen to pro-actively have their workers vaccinated, and I applaud those efforts. At this point in time, it's not a mandate.  But it is a prudent action to take, to protect your business, to get your staff vaccinated.

This story is produced by Arkansas Public Media. What's that? APM is a nonprofit journalism project for all of Arkansas and a collaboration among public media in the state. We're funded in part through a grant from the Corporation for Public Broadcasting, with the support of partner stations KUAR, KUAF, KASU and KTXK. And, we hope, from you!