Food contamination blamed for Juiz de Fora hepatite A surge as cases exceed 1,000

On a Tuesday afternoon in late May, the city council chamber in Juiz de Fora filled with residents and officials to confront a spreading crisis. More than a thousand cases of hepatitis A had been confirmed since December, concentrated in the central and southern neighborhoods—Centro, São Mateus, Cascatinha—and the outbreak showed no sign of stopping on its own. The Department of Epidemiological Surveillance presented its findings: food contamination, not water, was driving the surge. The water system had tested clean. But the disease was still moving through the city.

Louise Cândido, the department's chief, laid out what they knew and what remained uncertain. Laboratory analysis had ruled out the municipal water supply as a source of transmission. That was something. But it meant the contamination was happening elsewhere—in food preparation, in handling, in the gaps between farm and table. The city was pushing vaccination, particularly for adults over eighteen and children, and ramping up sanitary inspections across food distribution points. When asked about expanding the vaccination program more aggressively, Cândido was cautious. "We're not working with broad vaccination because we need technical criteria, but also the availability of the vaccine," she said. There were discussions underway about offering a second dose to children to catch those who had slipped through the first round. The city was also presenting its data to the National Immunization Program for review, hoping federal authorities might shift the criteria for who should be vaccinated.

The hearing had been requested by Councilman Sargento Mello Casal, who opened by noting the absence of health professionals—representatives from basic health units and hospitals had not shown up. The city's health secretary, Matheus Jacometti, was also absent. The Municipal Health Council had been hollowed out. These absences mattered. They suggested the machinery of public health was struggling to keep pace with the outbreak, that the usual channels of coordination and accountability were fraying under the pressure.

Amanda Florita sat in the chamber that day to represent her husband, Carlos Eduardo Silva Reis. He had died from hepatitis A. The confirmation of the cause had come through just hours before the hearing. "I'm here to represent my husband who died, the result came out today," she said quietly. "I don't have much to say." He was the second person in the city to die from the disease that year. His death was not abstract. It was a man who had lived in Santa Terezinha, a neighborhood where the virus was circulating. It was a wife left behind.

José Walter Guimarães, representing the Linhares neighborhood, stood to describe conditions on the ground: sewage leaks, open drainage ditches, dirty streets. In the middle of a hepatitis A outbreak, these were not minor complaints. They were the physical reality in which the virus moved. He was asking the city council to pay attention, to understand that disease does not spread in a vacuum—it spreads through neglect, through infrastructure that has failed, through the places where people have no choice but to live.

There was one piece of news that offered some relief. The city's epidemiological data showed the outbreak was decelerating. In week eleven of the year, when cases had peaked, the city recorded 132 new infections. By week eighteen, that number had fallen to fifteen—an 88.6 percent drop. But the numbers were still being updated. They were provisional. And even as the curve bent downward in Juiz de Fora, the city remained the epicenter of the state's outbreak. In April alone, the city accounted for 176 of the 197 cases confirmed across all of Minas Gerais—nearly ninety percent of the state total.

Hepatitis A spreads through contaminated food and water, and through close contact with infected people. Symptoms appear between fifteen and fifty days after infection: fatigue, fever, nausea, abdominal pain, and jaundice—the yellowing of skin and eyes that gives the disease its visible mark. The vaccine was available free through the public health system, but only for specific groups: children between fifteen months and five years, pregnant women, people with liver disease, the immunocompromised, people on HIV prevention medication, unvaccinated contacts of confirmed cases. The city was offering it at basic health units on weekdays starting at nine in the morning, and on Saturdays from eight to eleven. But availability remained constrained. The outbreak was moving faster than the vaccine supply could follow.