Traveled to St. Louis lately via Highway 67? You may want to ask yourself where you ate along the way.

The Arkansas Department of Health is warning that an employee of a Subway in Corning has tested positive for the hepatitis A virus. It’s the 12th reported case of the disease in Clay County since February, ADH said in a news release on Friday. (The Subway appears to be located in a gas station called Flash Market, which is located on the main thoroughfare in Corning.)

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“Anyone who ate at this facility between March 30 and April 17 should seek care immediately if they have never been vaccinated against Hep A or are unsure of their vaccine status,” the ADH release said. The department is also recommending that all food service workers in Clay County be vaccinated.

Those who have been exposed can prevent illness by getting the vaccine promptly, the ADH release says. Children under one year of age can receive a separate medicine regimen, it says. (Though … should you be feeding your 10-month-old Subway sandwiches?)

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Here’s the CDC’s page on the virus. There are an estimated 4,000 cases of the disease annually in the U.S.

Note that Hep A is a very different infection than hepatitis B or hepatitis C. All are inflammations of the liver caused by viruses, but Hep A is typically an acute disease caused by food contamination. The CDC website warns that Hep A can be fatal if untreated but says “most people who get hepatitis A feel sick for several weeks, but they usually recover completely and do not have lasting liver damage. In contrast, Hep C is typically a long-term, chronic infection and is usually transmitted by blood.

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The full press release:

Health Department Warns of Possible Hepatitis A Exposure to Customers of Corning, Ark., Flash Market/Subway

Little Rock, Ark. – The Arkansas Department of Health (ADH) is warning of a possible Hepatitis A (Hep A) exposure after an employee of the Flash Market/Subway, located at 105 North Missouri Avenue, Corning, tested positive for the virus. Hep A is a contagious liver disease.

Anyone who ate at this facility between March 30 and April 17 should seek care immediately if they have never been vaccinated against Hep A or are unsure of their vaccine status. There are no specific treatments once a person gets Hep A; however, illness can be prevented even after exposure by getting the vaccine or with a medicine called immune globulin. This medicine contains antibodies from other people who are immune to Hep A and works best if given within two weeks of exposure to the virus.
The Clay County Local Health Unit (LHU) in Corning will hold a walk-in clinic to provide vaccinations from 9 a.m. to 3 p.m. Saturday, April 21. The Corning LHU, located at 301 N. Missouri Suite 18, is also open from 8:45 a.m. to 3:30 p.m. Monday, April 23. Those people who cannot attend the clinic will need a vaccine or medicine in the next week in order to prevent illness. Anyone who ate at this location and does not live in the area should contact their LHU or their healthcare provider.

People without symptoms who have eaten at this Flash Market/Subway between March 30 and April 17, 2018 and are:

   *Under one year of age are too young to be vaccinated so should call their health care provider for medicine.
   *One year of age and older and have never been vaccinated for Hep A should get the vaccine. They can come to the Corning LHU during the hours posted above, or contact their local LHU or healthcare provider to get the vaccine. Those who are pregnant, have chronic illness or liver disease are especially encouraged to consult with their doctor for immune globulin (medicine).

Hep A is usually spread when a person ingests tiny amounts of poop from contact with objects, food or drinks contaminated by the feces, or poop, of an infected person. Hep A can also be spread through unprotected sex or sharing of injection drugs.

So far this year, 12 cases of Hep A have been reported in Clay County. Because four of the cases have involved food service workers, the ADH recommends that all food service workers in Clay County be vaccinated. The ADH has been working with local restaurants and food service facilities on this vaccination effort.

“This rise in cases is concerning,” said Dr. Dirk Haselow, State Epidemiologist. “We are encouraging everyone in the county and surrounding areas to be aware of the risk factors for getting Hep A. If you are engaged in any of these risky behaviors, please get vaccinated. If you experience symptoms, visit your healthcare provider.”

Typical symptoms of Hep A include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, or jaundice (yellowing of the skin or eyes). Hep A is a contagious liver disease that results from infection with the Hepatitis A virus. It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. A person can transmit the virus to others up to two weeks before and one week after symptoms appear.

The virus can cause illness anytime from two to seven weeks after exposure. If infected, most people will develop symptoms three to four weeks after exposure. Many people, especially children, may have no symptoms. The older a person is when they get Hep A, typically the more severe symptoms they have. Up to one in three adults are typically hospitalized. Almost all people who get Hep A recover completely and do not have any lasting liver damage, although they may feel sick for months. All 12 of the current cases have been in adults.

Hepatitis A is preventable through vaccination. Hepatitis A vaccine has been recommended for school children for many years, and one dose of Hep A vaccine is required for entry into kindergarten and first grade as of 2014. Most adults are likely not vaccinated, but may have been if they received vaccinations prior to traveling internationally. Please contact the local health unit in your county for more information about vaccination.