In September 2013 New York City health officials investigated a report of hepatitis A in an employee of New Hawaii Sea Restaurant located in the Bronx. The patient reported onset of fever, malaise, and anorexia on September 10, dark urine on September 13, and jaundice on September 15. The employee worked as a host at the restaurant and reportedly rarely handled food. Serologic testing was conducted on serum obtained from other New Hawaii Sea employees. None was found to have an acute infection.

The health department re-interviewed all non-travel hepatitis A patients identified through routine surveillance and learned that two patients had eaten at New Hawaii Sea on August 10. Ultimately 9 cases of hepatitis A were identified among 8 patrons and 1 employee. One ill person was a resident of New Jersey. Two secondary cases were identified among household contacts of one of the primary cases.

An inspection conducted on September 17, 2013 found two critical violations: bare hand contact with ready-to-eat food at the sushi bar and bare hand contact with crispy fried noodles. However because the index case who was a host at the restaurant rarely handled food and his illness onset was similar to ill restaurant patrons, health department investigators concluded that it was unlikely the employee was the source of the outbreak. No specific food item or ill employee or patron was identified as the source of the infection in this outbreak.