Health Tips - Warning From FDA Hepatitis A from Green Onion
Questions and
Answers on Hepatitis A Outbreaks
Associated with Eating Raw or Undercooked Green Onions (Scallions)
1.
What did FDA announce today? FDA advised consumers that three
recent hepatitis A outbreaks have been associated with eating raw or undercooked
green onions (scallions).
2.
Does this announcement apply to all products containing green onions?
No... It only applies to raw or undercooked green onions or products containing
them. Commercially prepared products, such as salsa in jars, have received a
treatment that eliminates the hepatitis A virus.
3.
What can consumers do to decrease their risk of infection from
hepatitis A caused by contaminated green onions? Consumers can cook all raw
green onions thoroughly before eating them. This minimizes the risk of illness
by reducing or eliminating the virus. Consumers can also avoid eating raw or
lightly cooked green onions. Consumers who wish to avoid undercooked green
onions should also specifically request that raw or lightly cooked green onions
not be added to their food prepared in restaurants.
4.
Should additional precautions be taken by people with chronic liver
disease or weakened immune systems such as patients undergoing chemotherapy or
AIDS patients? Persons ! with chronic liver disease or weakened immune
systems are not more likely to acquire hepatitis A. However, persons with these
chronic illnesses sometimes have a more severe form of hepatitis A. People with
chronic liver disease or weakened immune systems should consider avoiding raw
or undercooked green onions until the cause of green onion contamination has
been identified and corrected. All persons with chronic liver disease should
get hepatitis A vaccination (see below).
5.
What caused the outbreak of hepatitis A in the Pittsburgh area? The State of Pennsylvania , the Centers for Disease Control and
Prevention (CDC) and FDA are working together to investigate this outbreak. As
of November 15, 2003, the investigation is not finished, and it is not yet
known what caused this outbreak. Investigators are now trying to determine if
the outbreak was caused by a contaminated food such as raw or undercooked green
onions.
6.
Has FDA asked the restaurant industry to do anything in response to
these outbreaks? Yes. FDA has informed the restaurant industry of the
association of hepatitis A with raw or undercooked green onions in recent
outbreaks so that restaurants can take actions to protect their customers.
7.
What are the symptoms of hepatitis A? The average incubation
period for hepatitis A is 28 days (range: 15-50 days). This means that symptoms
of hepatitis A develop within 50 days of exposure.. Persons with hepatitis A
virus infection may not have any signs or symptoms of the disease. Adults are
more likely to have symptoms than children... If symptoms ! are present, they
usually occur abruptly and may include fever, tiredness, loss of appetite,
nausea, abdominal discomfort, dark urine, and jaundice (yellowing of the skin
and eyes). Symptoms usually last less than 2 months; a few persons are ill for
as long as 6 months. There is no chronic infection with the hepatitis A virus.
8...
How serious is hepatitis A? Most persons with hepatitis A make a
full recovery and will never get hepatitis A again... However, in rare
instances (an average of 3 in every 1000 reported cases), hepatitis A can be
fatal..
9. What should consumers do if they recently ate
food containing raw or lightly cooked green onions? Consumers who have
recently eaten raw or lightly cooked green onions and feel well only need to
monitor their health.. Consumers who are experiencing symptoms that might be
hepatitis A should consult their health care provider.
10.
Is there a test for hepatitis A? Yes, there is a
blood test for hepatitis A, called an IgM anti-HAV. However, the only people
who need this test are those who are showing symptoms of hepatitis A. Persons
who feel well should not be tested, even if they recently ate green onions.
11. What is immune globulin (often called IG or
ISG) and who should receive it? Immune globulin is a preparation of
antibodies that can be given before exposure to provide short-term protection
against hepatitis A to reduce the risk of infection among persons who have recently
been exposed to hepatitis A. For maximum protection immune globulin must be
given within 2 weeks after exposure. Persons who have recently eaten green
onions do not need to get immune globulin unless they have been specifically
exposed within the previous 2 weeks to individuals or food involved in an
outbreak and believe by public heal! th officials to have been potentially
contaminated.
12. Are there treatments for hepatitis A?
There is no medication that treats hepatitis A. Some patients with hepatitis A
may need to be hospitalized to treat dehydration or liver complications.
13. Is there a vaccine for hepatitis A? Yes,
but it should be given before an exposure to work most effectively. Hepatitis A
vaccine has been licensed in the United States for use in persons 2 years of age and
older. The vaccine is recommended for persons who are more likely to get
hepatitis A virus infection or are more likely to get seriously ill if they do
get hepatitis A. More information on vaccination can be found at http://www./.cdc.gov/ncidod/
14.. Have there been other recent outbreaks of
hepatitis A caused by contaminated food in the U.S. ? Have these outbreaks been associated
with raw green onions?
Yes. Hepatitis A outbreaks associated with raw or undercooked green onions
served in restaurants occurred in Tennessee , North Carolina and Georgia in September. The source of the green
onions from the Tennessee outbreak appears to be Mexico . The agency has been in consultation
with Mexican authorities to obtain their assistance in assessing the situation.
In addition, FDA is monitoring certain import entries of green onions for
evidence of potential contamination.