Distributed via Health Alert Network
November 15, 2003, 19:28 EST (7:28 PM EST)
CDCHAN-00164-03-11-15-ADV-NThe Food and Drug Administration is advising the public that
several recent hepatitis A outbreaks have been associated with eating raw or undercooked
green onions (scallions). Hepatitis A is a liver disease that develops within 6
weeks of an exposure. Hepatitis A is usually mild and characterized by jaundice (yellow
discoloration of the skin), fatigue, abdominal pain, loss of appetite, nausea, diarrhea,
and fever. It can occasionally be severe, especially in people with liver disease.
Hepatitis A outbreaks associated with raw or undercooked green onions served in
restaurants occurred in Tennessee, North Carolina and Georgia in September. Another
outbreak of hepatitis A among patrons of a single restaurant occurred in Pennsylvania
during late October and early November, although the source of the outbreak has not yet
been determined. CDC and the State of Pennsylvania have an investigation underway to
determine if a specific food is associated with the Pennsylvania outbreak, and if so, the
exact source. The source of the green onions in the Tennessee outbreak is Mexico.
FDA is continuing to investigate and is working with Mexican authorities to assess
appropriate measures. FDA offers the following advice to consumers concerned about the
possibility of getting hepatitis A from green onions:
- Cook green onions thoroughly. This minimizes the risk of illness by reducing or
eliminating the virus. Cook in a casserole or sauté in a skillet.
- Check food purchased at restaurants and delicatessens and ask whether menu items
contain raw or lightly cooked green onions. Consumers who wish to reduce the risk of
contracting hepatitis should avoid food that contains raw green onions and specifically
request that raw or lightly cooked green onions not be added to their food. Foods such as
freshly prepared salsa and green salads often contain raw green onions.
FDA, CDC and the States are actively investigating the outbreaks in an attempt to
determine the exact source of the green onions associated with the outbreaks and how they
became contaminated, so that corrective action can be taken.
While the investigations are ongoing, FDA will closely monitor the safety of green
onions and will take further actions as necessary to protect consumers. Consumers
who have recently eaten raw or lightly cooked green onions do not need to take any
specific measures, but should monitor their health. Consumers who are
experiencing symptoms that could be hepatitis A should consult their health care providers
or the local health department. FDA ON THE INTERNET:
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Categories of Health Alert messages:
Health Alert: conveys the highest level of importance; warrants immediate
action or attention.
Health Advisory: provides important information for a specific incident or
situation; may not require immediate action.
Health Update: provides updated information regarding an incident or
situation; unlikely to require immediate action.
## This Message was distributed to State and local Health Officers, Public
Information Officers, Epidemiologists and HAN Coordinators as well as Clinician
organizations. ##
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