--- title: Controlling foodborne hepatitis A outbreaks related to green onions date: 2005-09-21T09:36:24-07:00 author: Bill Marler canonical_url: "https://marlerclark.com/news_events/controlling-foodborne-hepatitis-a-outbreaks-related-to-green-onions" section: News --- [All News](/news_events) / # Controlling foodborne hepatitis A outbreaks related to green onions 21 Sep 2005 Novel use of genetic testing methods helped public health officials control and limit the further spread of four outbreaks of foodborne hepatitis A virus in 2003 related to the consumption of green onions, according to a detailed analysis published in the October 15 issue of The Journal of Infectious Diseases, now available online. The authors of the study, Joseph J. Amon, PhD, MSPH, and colleagues at the Centers for Disease Control and Prevention (CDC), explained that these molecular epidemiologic methods had not previously been used in an ongoing investigation of a hepatitis A virus outbreak. The methods, involving genetic sequencing analysis of virus found in blood samples from infected individuals, have greatly improved understanding of outbreaks of other foodborne pathogens, but are time-consuming and not widely available. In September 2003, Tennessee, North Carolina, and Georgia reported a total of 422 cases of foodborne hepatitis A virus infection to CDC. Preliminary investigations suggested clustering of reported cases among patrons of three unrelated restaurants. Investigators identified green onions as the likely culprit in the outbreak by interviewing infected and uninfected restaurant patrons. In addition to these standard techniques, the researchers also compared viral RNA sequences from case patients and individuals concurrently ill with hepatitis A virus infection in non-outbreak settings in the United States and Mexico. Viral RNA sequences from patients in the three states, plus patients involved in a subsequent outbreak in Pennsylvania in October 2003 (the latter recently described in the Sept. 1 issue of the New England Journal of Medicine), were slightly different from each other. The viral sequence from each outbreak, however, was identical to one or more sequences isolated from northern Mexican residents infected with hepatitis A virus. The researchers concluded that the sources of the green onions served in restaurants in Tennessee and Georgia were three farms in northern Mexico. Dr. Amon and colleagues credited the viral sequencing techniques with helping them to identify the relationships between the outbreaks in four separate locations, and to define the scope of the outbreaks quickly. The sequencing allowed them to determine if cases reported in other states were related to the four original outbreaks and provided reassurance that a larger outbreak was not occurring. The molecular epidemiologic methods also enabled public health officials to respond quickly to the later Pennsylvania outbreak. As a result, consumers were warned of the potential risk, and entry of green onions from four Mexican farms into the state was banned. “This research highlights the role of viral sequence analysis in improving our overall understanding of the roughly 50 percent of hepatitis A cases in the U.S. that are from an unknown source,” Dr. Amon said. “Just as the E. coli-contaminated beef outbreaks in the early 1990s prompted changes in epidemiological surveillance that have increased our knowledge of foodborne bacteria, the 2003 hepatitis A outbreaks demonstrated the potential for integrated molecular surveillance to provide a better understanding of the epidemiology of hepatitis A and facilitate rapid responses to outbreaks.” Founded in 1904, The Journal of Infectious Diseases is the premier publication in the Western Hemisphere for original research on the pathogenesis, diagnosis, and treatment of infectious diseases; on the microbes that cause them; and on disorders of host immune mechanisms. Articles in JID include research results from microbiology, immunology, epidemiology, and related disciplines. JID is published under the auspices of the Infectious Diseases Society of America (IDSA). Based in Alexandria, Va., IDSA is a professional society representing about 8,000 physicians and scientists who specialize in infectious diseases. For more information, visit http://www.idsociety.org. Steve Baragona sbaragona@idsociety.org 703-299-0200 Infectious Diseases Society of America http://www.idsociety.org ### Other Hepatitis A Lawsuits [La Serranita Concha Negra Frozen Clam Hepatitis A Outbreak Lawsuits](https://marlerclark.com/la-serranita-concha-negra-frozen-clam-hepatitis-a-outbreak-lawsuits) [Washington and California Hepatitis A Outbreak linked to Imported Strawberries](https://marlerclark.com/washington-hepatitis-a-outbreak-linked-to-imported-strawberries) [Hepatitis A outbreak - Strawberries sicken 27 in Canada and United States](https://marlerclark.com/hepatitis-a-outbreak-strawberries-sicken-27-in-canada-and-united-states) [Gino's Ristorante & Pizzeria linked to Hepatitis A Outbreak](https://marlerclark.com/ginos-ristorante-pizzeria-linked-to-hepatitis-a-outbreak) [Famous Anthony's Hepatitis A Outbreak; 52 sick, 36 hospitalized and 4 deaths](https://marlerclark.com/hepatitis-a-outbreak-linked-to-roanoke-famous-anthonys-restaurants) [Los Angelos Hepatitis A Outbreak linked to 555 East American Steakhouse](https://marlerclark.com/los-angelos-hepatitis-a-outbreak-linked-to-555-east-american-steakhouse) [Marler Clark retained in Hepatitis A cases linked to Fresh Thyme or Woodman’s blackberries](https://marlerclark.com/marler-clark-retained-in-nebraska-hepatitis-a-case-linked-to-fresh-thyme-farmers-market-blackberries) [Mendham Golf & Tennis Club Hepatitis A Outbreak](https://marlerclark.com/mendham-golf-tennis-club-hepatitis-a-outbreak) [Hawaii Hepatitis A Outbreak Linked to Genki Sushi Restaurants](https://marlerclark.com/oahu-hepatitis-a-outbreak-investigation) [New Hawaii Sea Restaurant Hepatitis A Outbreak](https://marlerclark.com/new-hawaii-sea-restaurant-hepatitis-a-outbreak) [Townsend Farms organic frozen berries from Costco and Harris Teeter linked to hepatitis A outbreak](https://marlerclark.com/townsend-farms-organic-frozen-berries-from-costco-linked-to-hepatitis-a-out) [A Tom's Gyro Restaurant Employee Tests Positive for Hepatitis A in Idaho](https://marlerclark.com/a-toms-gyro-restaurant-employee-tests-positive-for-hepatitis-a-in-idaho) ### Lawsuit updates about foodborne illnesses [Reactive Arthritis Lawsuit Updates](/news_events/case-news?illness=reactive-arthritis&year=all) [E. coli Lawsuit Updates](/news_events/case-news?illness=e-coli&year=all) [Guillain-Barre Syndrome Lawsuit Updates](/news_events/case-news?illness=guillain-barre-syndrome&year=all) [Salmonella Lawsuit Updates](/news_events/case-news?illness=salmonella&year=all) [Hemolytic Uremic Syndrome Lawsuit Updates](/news_events/case-news?illness=hemolytic-uremic-syndrome&year=all) [Listeria Lawsuit Updates](/news_events/case-news?illness=listeria&year=all) [Irritable Bowel Syndrome Lawsuit Updates](/news_events/case-news?illness=irritable-bowel-syndrome&year=all) [Hepatitis A Lawsuit Updates](/news_events/case-news?illness=hepatitis-a&year=all) [Norovirus Lawsuit Updates](/news_events/case-news?illness=norovirus&year=all) [Botulism Lawsuit Updates](/news_events/case-news?illness=botulism&year=all) [Campylobacter Lawsuit Updates](/news_events/case-news?illness=campylobacter&year=all) [Shigella Lawsuit Updates](/news_events/case-news?illness=shigella&year=all) [Cyclospora Lawsuit Updates](/news_events/case-news?illness=cyclospora&year=all) ### Lawsuits updates by year [Foodborne Illness Lawsuits in 1998](https://marlerclark.com/news_events/case-news?illness=all&year=1998) [Foodborne Illness Lawsuits in 1999](https://marlerclark.com/news_events/case-news?illness=all&year=1999) [Foodborne Illness Lawsuits in 2000](https://marlerclark.com/news_events/case-news?illness=all&year=2000) [Foodborne Illness Lawsuits in 2001](https://marlerclark.com/news_events/case-news?illness=all&year=2001) [Foodborne Illness Lawsuits in 2002](https://marlerclark.com/news_events/case-news?illness=all&year=2002) [Foodborne Illness Lawsuits in 2003](https://marlerclark.com/news_events/case-news?illness=all&year=2003) [Foodborne Illness Lawsuits in 2004](https://marlerclark.com/news_events/case-news?illness=all&year=2004) [Foodborne Illness Lawsuits in 2005](https://marlerclark.com/news_events/case-news?illness=all&year=2005) [Foodborne Illness Lawsuits in 2006](https://marlerclark.com/news_events/case-news?illness=all&year=2006) [Foodborne Illness Lawsuits in 2007](https://marlerclark.com/news_events/case-news?illness=all&year=2007) [Foodborne Illness Lawsuits in 2008](https://marlerclark.com/news_events/case-news?illness=all&year=2008) [Foodborne Illness Lawsuits in 2009](https://marlerclark.com/news_events/case-news?illness=all&year=2009) [Foodborne Illness Lawsuits in 2010](https://marlerclark.com/news_events/case-news?illness=all&year=2010) [Foodborne Illness Lawsuits in 2011](https://marlerclark.com/news_events/case-news?illness=all&year=2011) [Foodborne Illness Lawsuits in 2012](https://marlerclark.com/news_events/case-news?illness=all&year=2012) [Foodborne Illness Lawsuits in 2013](https://marlerclark.com/news_events/case-news?illness=all&year=2013) [Foodborne Illness Lawsuits in 2014](https://marlerclark.com/news_events/case-news?illness=all&year=2014) [Foodborne Illness Lawsuits in 2015](https://marlerclark.com/news_events/case-news?illness=all&year=2015) [Foodborne Illness Lawsuits in 2016](https://marlerclark.com/news_events/case-news?illness=all&year=2016) [Foodborne Illness Lawsuits in 2017](https://marlerclark.com/news_events/case-news?illness=all&year=2017) [Foodborne Illness Lawsuits in 2018](https://marlerclark.com/news_events/case-news?illness=all&year=2018) [Foodborne Illness Lawsuits in 2019](https://marlerclark.com/news_events/case-news?illness=all&year=2019) [Foodborne Illness Lawsuits in 2020](https://marlerclark.com/news_events/case-news?illness=all&year=2020) [Foodborne Illness Lawsuits in 2021](https://marlerclark.com/news_events/case-news?illness=all&year=2021) [Foodborne Illness Lawsuits in 2022](https://marlerclark.com/news_events/case-news?illness=all&year=2022) [Foodborne Illness Lawsuits in 2023](https://marlerclark.com/news_events/case-news?illness=all&year=2023) [Foodborne Illness Lawsuits in 2024](https://marlerclark.com/news_events/case-news?illness=all&year=2024) [Foodborne Illness Lawsuits in 2025](https://marlerclark.com/news_events/case-news?illness=all&year=2025) [Foodborne Illness Lawsuits in 2026](https://marlerclark.com/news_events/case-news?illness=all&year=2026) ##### Get Help #### Affected by an outbreak or recall? The team at Marler Clark is here to answer all your questions. Find out if you’re eligible for a lawsuit, what questions to ask your doctor, and more. [ Get a free consultation ](https://marlerclark.com/contact) ##### Related Resources ###### [Hepatitis A Food Poisoning](https://marlerclark.com/foodborne-illnesses/hepatitis-a/about-hepatitis) An Introduction to Hepatitis A Viral hepatitis is a major global public health problem affecting hundreds of millions of people and is associated with significant morbidity and mortality. Five biologically... ###### [The Incidence of Hepatitis A Infection](https://marlerclark.com/foodborne-illnesses/hepatitis-a/how-common-is-hepatitis-a-infection) How common is Hepatitis A infection? Hepatitis A incidence varies between regions and is much more common in countries with underdeveloped sanitation systems; thus, contracting hepatitis A is a risk... ###### [Transmission of Hepatitis A](https://marlerclark.com/foodborne-illnesses/hepatitis-a/how-does-hepatitis-a-spread) How does Hepatitis A spread? Hepatitis A is a communicable (or contagious) disease that is acquired primarily by the fecal oral route either from person to person or through contaminated... ###### [Symptoms of Hepatitis A Infection](https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-symptoms-risks) What are the symptoms of Hepatitis A infection? Hepatitis A may cause no symptoms at all when it is contracted, especially in children. Asymptomatic individuals may only know they were... ###### [Complications of Hepatitis A Infection](https://marlerclark.com/foodborne-illnesses/hepatitis-a/hepatitis-complications) Fulminant hepatitis A, or acute liver failure, can be a complication of hepatitis A infection. Fulminant hepatitis A is a rare but devastating complication of HAV infection. As many as... ##### Outbreak Database #### Looking for a comprehensive list of outbreaks? The team at Marler Clark is here to answer all your questions. Find out if you’re eligible for a lawsuit, what questions to ask your doctor, and more. [ View Outbreak Database ](https://outbreakdatabase.com)