Burger Boy in Caribou in September 2018. Credit: Chris Bouchard | Aroostook Republican

CARIBOU, Maine — Within the past month, four cases of hepatitis A in Aroostook County have been confirmed by the Maine Center for Disease Control. Dr. Regen Gallagher, DO, MBA, Chief Medical Officer at Cary Medical Center, said on Monday that these cases are “more than likely connected.”

While Maine is not experiencing an outbreak of the virus, 22 states in the country are. According to national CDC statistics there have been a total of 20,133 cases, 11,595 hospitalizations and 19 deaths as of June 14.

New Hampshire, which borders Maine, has had 79 cases since November 2018, according to the New Hampshire Department of Health and Human Services, a significantly high number compared to their annual average of six to seven cases.

In Aroostook County, the first case of the virus was identified in a Caribou food service worker on May 17, and while there is no longer a risk associated with going to the restaurant, the CDC warned that those who purchased food at the eatery between April 24 and May 2 are “outside the window for which prophylaxis is recommended” and that they should watch for symptoms.

Following the May 17 incident, one case was confirmed at Caribou High School on June 11, and over the weekend another case was confirmed at a Presque Isle Restaurant and a fourth was identified at Fort Kent Elementary School. The CDC has confirmed that no public health risk is associated with any of the aforementioned cases.

CDC Communications Director Jackie Farwell said on June 18 that while there is currently no public health risk, the organization recommends that “all food service workers get vaccinated for hepatitis A” and that the public take preventative measures, which include practicing good hand hygiene — including thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food.”

Cary’s Gallagher said that while she has not seen all of the patients diagnosed with the virus, the hospital is aware that some who have since tested positive did eat at the Caribou restaurant between April 24 and May 2.

She added that while this is a “likely connection,” it is also possible that the disease could have been transmitted by people who run in similar circles, through sexual contact, the sharing of needles, contact with blood or shared bodily fluids, or contaminated water.

“It is likely,” Gallagher said, “but I can’t absolutely say there is a connection without having spoken to some of the patients, the person involved in the original case, and knowing their history.”

While local medical facilities gave out close to 1,000 vaccinations shortly after the CDC first announced the virus, Gallagher said that the vaccination would not be effective for those who visited the restaurant from April 24 to May 2.

“This could happen at any establishment in the country,” Gallagher said, “as evidenced by the Presque Isle case,” adding that those who are concerned about the virus should practice good hand hygiene while preparing food and schedule a vaccination with their health provider.

According to the CDC website, some symptoms of the virus include “fatigue, low appetite, stomach pain, nausea, and jaundice.”

The CDC also indicates that vaccination is the best way to prevent the virus as “antibodies produced in response to hepatitis A infection last for life and protect against reinfection.”

Farwell said the CDC plans to “post additional information to CDC’s website when it becomes available.”