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Friday, April 22

Costco Food Product Recall associated with Hepatitis A Cases and Post Exposure Prophylaxis (PEP) Immunization Recommendations

April 29, 2016

The Canadian Food Inspection Agency (CFIA) posted a food recall due to possible Hepatitis A contamination. Information regarding this recall can be found at the CFIA website. The CFIA is advising consumers to not consume the recalled product. The recalled product has been sold exclusively at Costco warehouse locations in Ontario, Quebec, New Brunswick, Nova Scotia and Newfoundland and Labrador.

The Public Health Agency of Canada (PHAC), in collaboration with the affected provinces, including Ontario, are investigating the outbreak. There are currently 13 cases in Canada (ON: 10, NL: 1, QC:2). At this time, the Windsor-Essex County Health Unit (WECHU) has not been notified of any local cases of Hepatitis A.

Costco has contacted all customers who purchased the recalled product via automated phone calls. Costco is offering Hepatitis A vaccine to customers who have eaten the product in the last 14 days in order to decrease the risk of Hepatitis A. Costco has contracted a nurse to administer the Hepatitis A vaccine at the Costco location in Windsor until Sunday May 1, 2016. Please note that the nurse will need a physician prescription for Hepatitis A vaccine before it can be can administered. Alternatively, Costco has also indicated that it will reimburse customers the cost of one dose of the vaccine, if affected customers receive the vaccine through a health care provider.

After Sunday, Costco will no longer administer the vaccine on site. Costco will fill your prescription free of charge and you will need to bring the vaccine to your physician for administration. In order to safely transport the vaccine to your physician you will require a cooler bag with an ice pack. Alternatively, you may call the Windsor Essex County Health Unit 519 258-2146 ext. 1200 to make an appointment to receive the vaccine. A prescription is not required.

Publicly funded Hepatitis A vaccine can be ordered by health care providers for this recall through the health unit by calling 519-258-2146 ext. 1121. Vaccine will be released to the health care provider only and will not be dispensed directly to the client.

Recommendation for post-exposure prophylaxis

If within two weeks of last exposure:

  • Everyone 6 months of age and over should be offered hepatitis A vaccine as soon as possible (unless contraindicated, fully immunized in the past or already immune– see below for details).
    • Hepatitis A vaccine is not authorized for children less than 1 year of age, however, NACI has recently recommended its off-label use for children 6 months to 1 year of age.
  • Infants < 6 months of age require no intervention except for careful attention to hygiene when diapering etc. to prevent fecal oral spread. Considerations should be given to offering hepatitis A vaccine to their family members.
  • Immune globulin, which was previously recommended for infants, is generally not recommended, although could be considered on a case by case basis in infants less than six months of age who are at very high risk for liver complication (e.g. severe liver disease).

Individuals with chronic liver disease should be:

  • Offered Hepatitis A vaccine if within two weeks (14 days) of last exposure (unless contraindicated, fully immunized in the past or already immune – see below for details);
  • Advised to consult their health care provider if within six weeks of exposure (i.e., a maximum incubation period) for monitoring and advice regarding serum immune globulin
    • Serum immune globulin is unlikely to be of any benefit if more than three weeks have passed since last exposure.

Those previously vaccinated with Hepatitis A vaccine:

  • If two previous doses were provided, no additional doses are recommended.
  • If one dose was provided less than 6 months ago, no additional doses are recommended until at least 6 months from the last dose.
  • If one dose was provided 6 months or more in the past, one additional dose is recommended.

What other recommendations should be provided for people who have been exposed to the recalled frozen berry products?

  • Hand hygiene recommendations: Hand hygiene after using the washroom or changing diapers and before preparing food for others should be emphasized.
  • Seek medical care if symptoms develop: If symptoms develop in an individual who consumed the recalled product in the past six weeks, they should be advised to:
    • not prepare food for others
    • seek medical attention
    • notify their physician of their exposure
    • ensure blood is submitted for serology, and
    • Ensure the local public health unit is notified.

If you have further questions or concerns, please contact the Windsor-Essex County Health Unit at (519) 258-2146 ext. 1447 or ext. 1430.

Thank you.

Dr. S. Wajid Ahmed, MBBS, MAS, MSc, FRCPC
Associate Medical Officer of Health
Windsor-Essex County Health Unit