To the Editor.—
Public Health authorities have long banned the sale of shellfish caught in contaminated waters because of the danger of typhoid fever transmission.1,2 The discovery that shellfish can also transmit hepatitis has strengthened the importance of this ban. While definite outbreaks of hepatitis have occurred when contaminated shellfish have entered commercial distribution, Koff et al3 demonstrated that eating raw shellfish may be an important mode of transmission for many cases of sporadic hepatitis. They found that steamed (but not fried) clams appear to be epidemiologically implicated as well. They also demonstrated that temperatures during steaming of clams are not high enough or maintained long enough to inactivate the hepatitis virus.4 However, a case of hepatitis directly associated with eating steamed clams has not been documented. This paper reports a small outbreak from contaminated clams and emphasizes the risk of obtaining shellfish from contaminated waters.
Report of a
Feingold AO. Hepatitis From Eating Steamed Clams. JAMA. 1973;225(5):526–527. doi:10.1001/jama.1973.03220320054027