Skip to main content
King County logo

AT-A-GLANCE

  • Cases: 5
  • Hospitalizations: 2
  • Deaths: 0
  • Status: Investigation is ongoing
  • Locations: Señor Moose, 5242 Leary Ave NW, Seattle, WA 98107
  • Meal dates: February 24, 25 and 26
  • Current food safety rating: NEEDS TO IMPROVE

Highlights

Updated May 4, 2020

Summary

Public Health is investigating an outbreak of hepatitis A with jaundice (yellowing of the eyes and skin), abdominal pain, vomiting, diarrhea, and fever associated with Señor Moose restaurant in Seattle.

Illnesses

Since April 15, 2020, Public Health has learned of 5 people from 5 separate meal parties becoming ill with jaundice, abdominal pain, nausea, vomiting, fever and fatigue after consuming food from Señor Moose restaurant between February 24 and February 26, 2020. There is no indication that any current or former employees of the restaurant have had illnesses consistent with hepatitis A.

This outbreak is occurring while there is an ongoing local outbreak of hepatitis A among persons experiencing homelessness. In July 2019, Washington state declared a statewide hepatitis A outbreak among people living homeless or who use drugs. More recently, the Ballard area, where Señor Moose is located, has had a cluster of hepatitis A cases among people experiencing homelessness; none of the five cases described above reported any connection to persons experiencing homelessness or who use drugs.

Genetic testing of 2 of the 5 cases associated with Señor Moose match the local outbreak strain affecting people experiencing homelessness or who use drugs. The remaining three cases associated with Señor Moose are pending genetic testing at the Centers for Disease Control and Prevention (CDC). Genetic testing results suggests the cluster associated with Señor Moose is part of the larger outbreak among people experiencing homelessness or who use drugs. Public Health’s investigation of this restaurant cluster is ongoing to help determine how hepatitis A entered the restaurant.

Public Health actions

Due to the ongoing response to COVID-19 and the current recommendations for social distancing, initial outreach to the restaurant was conducted over the phone to minimize risk of exposure. Environmental Health investigators held a teleconference with restaurant management on April 17, 2020. Investigators reviewed food handling practices, illness policies, employee schedules, employee health, and facility cleaning, sanitizing, and disinfection procedures with the restaurant management to identify possible risk factors for the spread of hepatitis A. The restaurant was closed for cleaning and disinfection on April 17, 2020 at 1:30 p.m.

Investigators interviewed all current and former employees about health history, job duties, and food handling practices. No ill employees were identified.

An Environmental Health investigator visited the restaurant on April 19, 2020 to review food handling practices at the establishment and to verify proper cleaning and disinfection was completed and all ready-to-eat foods were discarded.

The investigator reviewed the requirement with management that if staff become ill with hepatitis A, they are not allowed to work until it has been at least 7 days since jaundice onset AND they are symptom-free for at least 24 hours, indicating that they are no longer contagious. The investigator provided education about preventing the spread of hepatitis A — including proper handwashing, preventing bare hand contact with ready-to-eat foods, and reinforced illness policies, facility cleaning, sanitizing, and disinfection, and vaccination.

Prior to reopening for business on April 20, 2020, the business was required to establish and review employee illness policy with all employees and ensure all employees received food safety training before they begin their shift.

Environmental Health investigators held another teleconference with restaurant management on April 23, 2020 to discuss 2 additional cases of hepatitis A, which were identified by Public Health investigators after the initial April 20, 2020 investigator visit and restaurant re-opening.

Given that the restaurant had closed and completed appropriate interventions to eliminate the risk of spread of hepatitis A, and that these 2 additional cases had meal dates in the same late-February 2020 time period as the previously-identified 3 cases, Public Health allowed the restaurant to remain open at this time.

Restaurant management is working cooperatively with Public Health to identify and improve food safety practices.

Public Health held one clinic to provide hepatitis A vaccine to employees and is working with the restaurant to schedule a second clinic to vaccinate the remaining employees.

Laboratory testing

Five people who got sick tested positive for hepatitis A and had elevated (abnormal) liver enzyme testing consistent with acute hepatitis. Patient specimens were sent to the CDC for genotyping. Genetic testing of two of the five people matches the local outbreak strain affecting people experiencing homelessness or who use drugs, suggesting the cluster associated with Señor Moose is part of the larger outbreak among people living homeless or who use drugs since April 2019.

Report possible foodborne illness

About Hepatitis A

  • Hepatitis A virus infects the liver and can cause illnesses that range from a mild infection that has no symptoms to a more severe illness that can last for months.
  • In rare occasions, it can cause liver failure and death.
  • Hepatitis A virus spreads easily. It is usually transmitted person-to-person through the fecal-oral route or consumption of contaminated food or water.
  • It gets into the body through the mouth after someone touches an object, food, or drink that is contaminated with the virus. If an infected person doesn’t wash their hands well, especially after using the toilet, undetectable amounts of the virus can spread from the hands of that person to other objects, surfaces, and foods. Most cases occur through eating contaminated food.
  • Most children younger than age 6 do not have symptoms when they have hepatitis A. When symptoms are present, young children typically do not have jaundice but older children and adults with hepatitis A have jaundice.
  • Hepatitis A virus infects the liver and can cause illnesses that range from a mild infection that has no symptoms to a more severe illness that can last for months.
  • In rare occasions, it can cause liver failure and death.
  • Hepatitis A virus spreads easily. It is usually transmitted person-to-person through the fecal-oral route or consumption of contaminated food or water.
  • It gets into the body through the mouth after someone touches an object, food, or drink that is contaminated with the virus. If an infected person doesn’t wash their hands well, especially after using the toilet, undetectable amounts of the virus can spread from the hands of that person to other objects, surfaces, and foods. Most cases occur through eating contaminated food.
  • Most children younger than age 6 do not have symptoms when they have hepatitis A. When symptoms are present, young children typically do not have jaundice but older children and adults with hepatitis A have jaundice.
  • If symptoms occur, they usually start about 4 weeks after exposure, but can occur as early as 2 weeks and as late as 7 weeks after exposure.

Prevention

General advice for reducing risk of contracting hepatitis A:

  • Get the hepatitis A vaccine series from your doctor or pharmacy (call ahead to make sure they have vaccine available)
  • Wash hands, cutting boards, and counters used for food preparation immediately after use to avoid cross-contamination of other foods.
  • Wash hands thoroughly with soap after using the bathroom or changing diapers, and before preparing any food or eating.
  • Wait at least 7 days after jaundice onset AND 24 hours after the last episode of vomiting and/or diarrhea before preparing food for others.

More information about norovirus:

Link/share this page at www.kingcounty.gov/outbreak/senor-moose