HONOLULU (HawaiiNewsNow) - The state is investigating a pair of Hepatitis A cases on Kauai.
Investigators say the symptoms of the patients in these cases – which were first observed in November – are consistent with a strain responsible for a deadly outbreak of the disease in California.
Hundreds of people have been sickened in that outbreak and more than 19 people have died.
The state is warning Hawaii travelers who have visited the mainland, particularly the San Diego area, to be aware that they may have become infected during their trip.
"As our investigators continue their work, we want to remind Hawaii residents that hepatitis A vaccination is highly effective in preventing infection," said Dr. Sarah Park, state epidemiologist. "With large, multi-state outbreaks occurring across the country, it is important that we all take precautions to prevent hepatitis A infection."
The state did not release any additional information about the newly-reported cases on Kauai.
Hepatologist Dr. Naoky Tsai said he's surprised the virus didn't arrive in Hawaii sooner.
"We have so many trips between here to San Diego, it should be very quickly transmitted," Dr. Tsai said.
The outbreak spread quickly in homeless camps throughout San Diego, leaving nearly 400 hospitalized.
Since September 2017, public health agencies have installed dozens of hand-washing stations and cleaned streets with bleach-spiked water.
Hawaii's outreach workers say they are armed with their own tools to promote cleanliness.
"Our donors provide us with millions of hygiene products," said Kimo Carvalho with the Institute for Human Services. "We actually package and provide them to clients on the street to prevent these types of outbreaks."
Hawaii is no stranger to Hepatitis A cases.
Clinics and pharmacies across Oahu reported a surge in patients last May when it was reported that poke that tested positive for the virus had been sold at several eateries. An outbreak of Hepatitis A in Hawaii in 2015 sickened hundreds of people, and at least one woman who ate tainted scallops died of liver failure.
Symptoms of Hepatitis A infection include fever, fatigue, loss of appetite, abdominal discomfort, dark urine, diarrhea, and yellow skin and eyes. State health department officials say a medical advisory has been distributed to physicians statewide warning of the newly-discovered cases.