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Ecosure food safety monitor
August 2019

The EcoSure Food Safety Monitor is a free monthly newsletter written by EcoSure Food Safety & Public Health experts. EcoSure is a division of Ecolab.

Hepatitis A

When we look at the top 5 pathogens that cause foodborne illness in the United States, they are Norovirus, Salmonella, Clostridium perfringens, Campylobacter and Staphylococcus aureus

There are also pathogens that aren't as common but have a higher likelihood to lead to hospitalization and these are Listeria monocytogense, E. coli, and Vibrio. 

Hepatitis A is not listed in the top foodborne illness pathogens. However, its incidence across North America has increased since 2016. 

What Is Hepatitis A

Hepatitis A is a virus that attacks the liver.  It can be spread through promiscuous activity or contamination through food if it is handled by an infected person.  A challenge with hepatitis A, is that infectious individuals may not know they are sick because symptoms such as fever, nausea and yellowing of the skin can take up to 2 weeks to develop after infection. Although anyone can get hepatitis A, in the United States, certain groups of people are at a higher risk

Widespread Outbreak

Hepatitis A has been responsible for >23,000 cases in just over 3 years. Since the outbreaks were first identified in 2016, 29 states have publicly reported cases. While outbreaks in California are declared over, Kentucky is reporting >4000 current cases.

Prevention of Hepatitis A

Since the vaccine first became available in 1995, hepatitis A rates have declined by more than 95%. Public Health officials have stated the importance of vaccination for optimal control. The CDC recommends people that are at highest risk get vaccinated. Some US states offer free or low-cost vaccination clinics.

Few jurisdictions require Hep A vaccinations for food service workers. One that does is the City of St. Louis. In 1999, it set an ordinance requiring every establishment holding a food permit, and operating more than 10 days, to verify a certificate of Hep A immunization from every food handler within 30 days of employment.

Although Hepatitis A is one of the only foodborne illnesses that has a vaccination available, it can be prevented in other ways.

The importance of handwashing cannot be undervalued.  Handwashing is the #1 way to prevent the spread of disease.  Hands should be washed after using the restroom, before handling food, after contamination of hands during food preparation and after dirty activities.
glove & Utensil use
Do not handle food with your bare hands that will be eaten without further cooking. This includes not touching produce, cooked foods or garnishes without utensils or hands that have been washed and then have been covered with gloves.
exclude sick food handlers
If someone is sick with diarrhea or nausea, they should not be handling food.  Someone that has yellowing of the skin has classic symptoms of Hep A.

Key Takeaway:

Food handlers must execute excellent personal hygiene behaviors, not handle RTE and fully cooked food with bare hands and stay home when they are sick

For more information from helpful and trusted resources, look here:

  • Regular CDC “at a glance” map and cases updates
  • Ecolab’s information on how hepatitis A enters a restaurant and can be prevented
  • Michigan’s Department of Health has posters with important Hep A info. for food employees in 5 different languages

English  Arabic  Chinese   Korean  Spanish

If you have questions on resources for Hepatitis A, reach out to public health partners. 

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The EcoSure Food Safety Monitor is a free monthly newsletter covering federal and state regulatory updates, current research, seasonal food safety issues, "hot" topics in food safety and more. The newsletter is written by EcoSure Food Safety and Public Health Manager Mandy Sedlak.


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