L.A. Schools’ Hepatitis Fear Nears an End

A hepatitis A scare that was kicked off when possibly tainted strawberries made their way into Los Angeles public school lunches should soon be over, according to public health officials.

No cases of infection by the highly contagious virus have been linked to consumption of fruit cups containing the berries, according to Dr. David Dassey, a Los Angeles County epidemiologist.

The strawberries came from a shipment linked to three hepatitis outbreaks in Michigan. They were served to students and employees in 18 Los Angeles Unified School District cafeterias in March.

Although there is a slight possibility that symptoms could still surface among individuals infected by the virus, the most likely incubation period is over, Dassey noted.

“We’ve gotten through the hump in the bell curve,” he said.

County epidemiologists and school district officials will continue to monitor students and employees until the end of May, Dassey said.

Public health experts said it is unknown whether an outbreak was averted by the swift inoculation of thousands of those who had eaten the fruit or simply good luck. After all, they said, it has never been certain that the strawberries were contaminated.

The strawberries, served in four-ounce frozen fruit cups, were grown and frozen in Mexico and shipped to Michigan, Arizona, Florida, Georgia and Southern California as part of the U.S. Department of Agriculture school lunch program.

The shipment was divided into 13 lots, some of which were believed to be contaminated because of a hepatitis A outbreak in which more than 150 students in Calhoun County, Michigan, fell ill.

School officials in Michigan did not know which lots of strawberries were served to the students who were infected. Los Angeles officials had the same uncertainty about the strawberries it served.

Local school and county health specialists decided that the risk was great enough to begin the inoculation program.

Several thousand students and employees were promptly given shots to boost their immunity to the virus. Older students who said they had been served the desserts but did not eat them were not vaccinated.

The shots were offered free at the schools, and some individuals were inoculated by their personal physicians.

The immune serum globulin shots are almost always effective when given within 14 days of exposure.

“Did [an outbreak] not occur because of something we did, or did it not occur because nothing would have happened anyway? There’s never any way to be 100% conclusive,” Dassey said.

Since the suspect strawberries were eaten in late March, teachers and school nurses have been on the lookout for students who have been ill for more than three days, have acute gastrointestinal symptoms or are jaundiced.

Although several students suspected of hepatitis A infection from the fruit cups have been referred to county health officials, all tested negative for the virus, Dassey said.

One case of hepatitis A did turn up, but health officials believe that the child was infected by a sibling who was infected by a guest in the family’s home, Dassey said.

School food service officials, meanwhile, have reported no drop in the number of students eating in school cafeterias.

A virus that affects the liver, hepatitis A is shed from the intestinal tract of an infected person through feces. The disease is transmitted when these particles contact another person’s mouth, usually through consumption of contaminated food. The disease also can be spread by physical contact with an infected person.

Hepatitis A is generally not considered to be as severe as type B, which is spread through the exchange of bodily fluids.

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BACKGROUND

The scare focused on strawberries harvested in Mexico, processed in San Diego and shipped to Michigan, Arizona, Florida, Georgia and Southern California as part of USDA-sponsored school lunch programs. In the Los Angeles Unified School District, strawberry-blueberry fruit cups containing possibly tainted fruit were eaten in late March by as many as 9,000 students and employees at 13 elementary, two middle and three high schools. After a hepatitis A outbreak in Michigan believed to be caused by the strawberries, a weeklong inoculation program was conducted at the affected Los Angeles schools.