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American Journal of Epidemiology Vol. 129, No. 1: 155-164
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

other

HEPATITIS A OUTBREAK ON A FLOATING RESTAURANT IN FLORIDA, 1986

PHILIP W. LOWRY1 5,, ROBERT LEVINE2,6, DONNA F. STROUP3, ROBERT A. GUNN1, MICHAEL H. WILDER4 and CHARLES KONIGSBERG, JR.2

1Division of Field Services, Epidemiology Program Office, Centers for Disease Control Atlanta, GA 30333
2Broward County Health Department Fort Lauderdale, FL
3Florida Department of Health and Rehabilitative Services Tallahassee, FL
4Division of Surveillance and Epidemiologic Stud ies, Epidemiology Program Office, Centers for Disease Control Atlanta, GA
6Currently with the Nassau County Department of Health, Mineola, NY

Send reprint requests to Dr. Philip W. Lowry at this address.

Lowry, P. W. (CDC, Atlanta, GA 30333), R. Levine, D. F. Stroup, R. A. Gunn, M. H. Wilder, and C. Konigsberg, Jr. Hepatitis A outbreak on a floating restaurant, Florida, 1986. Am J Epidemiol 1989;129:155–64.

In April and May 1986, the largest reported foodbome outbreak of hepatitis A In Florida state history occurred among patrons and employees of a floating restaurant. A total of 103 cases (97 patrons and six employees) were identified. The exposure period lasted 31 days (March 20–April 19), making this the most prolonged hepatitis A outbreak to occur in a restaurant that to date has been reported to the Centers for Disease Control. The exposure period was divided Into time intervals (peak, early, late, and total) for calculation of food-specific attack rates. The authors showed that green salad was an important vehicle of transmission for each phase of the exposure period, with the highest adjusted odds ratio for the three-day peak exposule interval (March 28–30), 6.8 (p = 0.001). Non-salad pantry Items and mixed bar drinks were also Identified as vehicles of transmIssion; both were more important during the early Interval of the exposure period than during the late interval. Two of six Infected employees worked In the pantry and may have sequentially Infected patrons. Though rare, this outbreak suggests that hepatitis A Infection among employees may allow for transmission to patrons for prolonged periods of time. Prevention of such out breaks requires prompt reporting of Ill patrons with rapid Identification of infected employees and correction of food handling practices.

epidemiologic methods; food contamination; hepatitis; hepatitis A

5Current address: Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA 94305.


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