HONOLULU (HawaiiNewsNow) - A growing Hepatitis A outbreak that's sickened nearly 170 people in the islands has been linked to frozen, "wild harvest" scallops from the Philippines served raw at Genki Sushi eateries on Oahu and Kauai.
Eleven of the popular chain's eateries have been shut down, ordered to throw away all of their food and disinfect from floor-to-ceiling.
On Tuesday afternoon, the Health Department identified the product of concern as Sea Port Bay Scallops, distributed by Koha Oriental Foods to Genki Sushi restaurants on Oahu and Kauai.
Distributor True World Foods had the same type of scallops and was set to send them to Genki Sushi eateries on Maui and the Big Island, but health inspectors were able to impound the tainted product at an Oahu warehouse before it was distributed.
Washington state-based Sea Port Production Corp. says on its website that the wild-caught Philippine Bay scallops are harvested primarily in the southwestern region of Masbate. Divers catch the scallops, and shuck them onshore.
Koha Oriental Foods said Genki Sushi was the only client that bought the tainted product, and the distributor has since changed where it gets scallops.
"We are caught right in the middle," said Dane Nakamura, of Koha Foods.
"We haven't sold this product to other sushi or other establishments. This is only Genki, and we provided all that information to the Department of Health, and maybe that's what really narrowed them down to Genki and that one product."
Genki Sushi 'shocked' over tainted scallops
The state Health Department announced Genki Sushi's link to the outbreak on Monday afternoon, shortly after ordering the chain to close down its 10 locations on Oahu and one on Kauai.
Dr. Sarah Park, state epidemiologist, said anyone who ate at Genki Sushi on Oahu and Kauai in the last two weeks should consult a healthcare provider, and seek a vaccine. For customers who ate at Genki Sushi more than two weeks ago, it's too late to get a vaccine to protect against getting sick. Instead, they should monitor their health for at least 50 days.
The Oahu and Kauai restaurants closed abruptly during the dinner hour Monday to prevent any further illnesses and protect the public.
Mary Hansen, chief administrative officer at Genki, said company officials were "shocked" to hear that the eateries were linked to the outbreak.
"Genki Sushi cares about our customers health and safety. We immediately complied with the order," she said, in a Tuesday news conference.
Customers caught off guard
But some customers were concerned that Genki Sushi employees didn't tell them why they were closing Monday.
Brenda Garcia was at Genki Sushi in Pearl City when an employee came by to tell customers that the eatery was closing down, and to "just finish up your food order."
Patrons were also being turned away at the door. The customers said they weren't notified that it was because of the Hepatitis A outbreak.
"Nobody said anything," said customer Charly Borce, adding that employees instead told him there was a problem with the eatery's sushi conveyor belt. "They were just saying that the belt was broken. But still get guys eating there so I don't know."
Other customers leaving the Kaneohe location said they were shocked that they hadn't been told.
Hawaii News Now asked a Kaneohe supervisor why diners weren't being told what was happening, who said employees had only been informed by upper management that they needed to close.
On Tuesday, health officials said the restaurants were not required to notify their customers of the reason for the closure.
Eateries get top-to-bottom cleaning
At Oahu and Kauai locations on Tuesday, Genki Sushi employees were scrubbing surfaces high and low, and throwing out food stock and single-use products.
Peter Oshiro, Health Department sanitation branch chief, said the eateries were told to sanitize and disinfect everything, and stress the importance of hand-washing among employees.
Food inspectors are visiting the 11 locations Tuesday. The eateries will begin to open as soon as they've complied with the Health Department's orders.
"Genki Sushi in Hawaii has a history of good compliance with food safety regulations, which includes good employee hygiene," Oshiro said. "We will continue to work with Genki Sushi restaurants to ensure their safe operation after the investigation is completed."
Tracking down the source
The state's Hepatitis A outbreak, one of the largest in the nation over the last two decades, has confounded state health officials for two months.
The first cases were announced July 1, but officials now believe the outbreak started as early as April 15. As of last week, the outbreak has sickened a confirmed 168 people; 46 have required hospitalization.
State health officials have said they struggled to find the source of the outbreak, despite scores of people working on the problem, because of the long incubation period. They hinted that the source may never be found.
But they had a breakthrough thanks to a survey for all Hawaii households aimed at tracking the population's dining out and shopping habits.
The survey found that about 23 percent of households had eaten recently at a Genki Sushi restaurant, but at least 70 percent of those who had fallen ill ate there recently. No other eatery or grocery store had a similar result.
"Because of the survey, we were able to determine that there was a distinct difference of eating habits at Genki compared to the regular population," Park said. "But our investigation is not over yet. We know that while the majority are associated with Genki, we don't know where the small minority may have also consumed the product."
Hepatitis A outbreaks rare
Complicating the search for the source of the outbreak was that Hepatitis A outbreaks have become far less common than in previous decades, thanks to a widely-available vaccine and more stringent food regulations.
The last outbreak of Hepatitis A in the United States happened in 2013, and was linked to frozen pomegranate seeds from Turkey. Some 162 cases nationally were linked to that outbreak; eight cases in Hawaii were reported, according to the CDC.
In 2014, the latest year for which data is available, there were about 2,500 cases of Hepatitis A in the United States, the CDC said.
The largest Hepatitis A outbreak in the United States over the last two decades happened in 2003, when 935 people across several states got sick. The outbreak was eventually linked to green onions.
Hepatitis A is usually spread via contaminated food or water. Symptoms include fever, fatigue, loss of appetite, abdominal discomfort, dark urine, diarrhea, and yellow skin and eyes.