Hepatitis A outbreak strikes elite enclave known as playground for the rich
State health authorities warned this week that anyone who ate at The Red Inn in wealthy Provincetown, Massachusetts, may have been exposed to the liver infection that is spread through contaminated food and water.
The Massachusetts Department of Public Health said anyone who ate at the restaurant between April 30 and May 15 should seek medical attention immediately.
An food service employee working during that time period tested positive for the disease.
The department said customers who think they were exposed within the last two weeks and have no symptoms may be able to get treated with antibodies and a vaccine, which is 94 percent effective for several years.
The Red Inn is currently 'open and safe to dine at,' and the restaurant is 'cooperating fully' with health authorities, Provincetown officials said in a statement.
No additional illnesses have been reported, and it's unclear how many customers were exposed during that timeframe.
The infected employee is 'recovering well' and 'remaining out of work' for the time being.
Lezli Rowell, Provincetown Health Department Director, said: 'From my experience inspecting The Red Inn through the years, this is not a facilities issue.
'The staff is knowledgeable, trained in food safety and committed to best management practices, and the back of the house is top-notch.
'This is just an unfortunate illness that happened to an individual who is reported to be recovering well and remaining out of work until medically cleared to resume food handling employment.'
The Red Inn is a 200-year-old restaurant and hotel serving tourists to the wealthy Cape Cod destination, many of whom make $200,000 per year, more than twice the national average, according to research firm Placer.ai.
The CDC estimates 180,000 Americans are struck by hepatitis A every year, many of whom have no symptoms, which include fever, nausea, abdominal pain, jaundice, dark urine and hives.
The disease spreads when infected stool enters a person's mouth, often by eating or drinking contaminated food or water.
It also may spread through kissing, hugging, sharing utensils or having sex with an infected person.
Once the virus enters the body, it infects liver cells and causes inflammation. Most cases go away on their own with no permanent damage, but it could take up to six months for symptoms to disappear entirely.
There is no treatment for the condition other than antibody therapy and vaccines within two weeks of exposure.
Dr Paul Sax, clinical director of infectious diseases at Brigham and Women's Hospital in Boston, told local news: 'It's not the kind of illness like a typical food poisoning where you're sick for one or two days, then you're back to normal within a week.
'Usually, people with hepatitis A, at least the people who get diagnosed, are out for two to three weeks, sometimes longer.'
In extremely rare cases - one in 5million people - the infection can be fatal due to severe liver failure.
Massachusetts health officials urged people who may have been exposed to get vaccinated within two weeks, as the first dose is only effective for that period. A second dose six months later provides protection for several years and is 94 percent effective.
Dr Sax said: 'It makes sense for people to get vaccinated for hepatitis A. Our hepatitis A vaccine is one of the safest and most effective vaccines that we have.'
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