Oyster-Associated Hepatitis-Reply

In Reply.— Dr Ingham expresses doubt that the oysters implicated in the Houston and Calhoun, Ga, oysterassociated hepatitis epidemics actually originated from the certified shellfish growing areas and were not bootlegged from illegal, contaminated areas. Much of the evidence against bootlegging was not published in the report, for brevity. In addition to the two outbreaks reported, there was an outbreak of oyster-associated hepatitis involving a seafood restaurant chain. Five cases were traced to raw oysters purchased from a Louisiana seafood supplier different from the one implicated in the Houston and Calhoun outbreaks. This supplier had harvested oysters from the same growing area as the oysters implicated in the two previously reported outbreaks. 1 Furthermore, an investigation in Louisiana demonstrated a large increase in the incidence of hepatitis cases in which patients reporting having eaten raw oysters, compared to that incidence in a control period. These nonepidemic cases were traced to