Hepatitis A and Food Service Workers (infectious hepatitis)
You may have seen news reports concerning a Hepatitis A outbreak in the Southern Calif. area specifically San Diego and L.A. areas. Here are FAQs concerning Hepatitis A as it relates to food handling and safety.
What is Hepatitis A?
There are several Hepatitis viruses (Hepatitis A, B, C, D and E) that cause human liver disease. Of the five virus types, only Hepatitis A can be transmitted by food through the fecal-oral route and is considered a major foodborne disease agent.
What are the symptoms of Hepatitis A?
Hepatitis A disease begins with mild symptoms, such as fever, headache, weakness, nausea and vomiting, after an average incubation period of four weeks. The infectious dose is presumed to be as low as 10 to 100 virus particles. The classic yellowing of the skin (jaundice) and dark-colored urine may appear at the onset of symptoms or later. Abdominal tenderness may occur, due to enlargement of the liver or spleen. The illness is usually more severe in adults than children. More than half of those children infected with Hepatitis A virus will show no symptoms, but infected individuals will shed the virus in their feces for a period of time.
How is the virus transmitted?
Transmission of Hepatitis A occurs primarily from direct or indirect fecal contamination. The virus particles are shed in the feces by infected individuals for several weeks often before the onset of disease symptoms. The FDA states that water, salads and seafood are the most common vehicles. However, many outbreaks have been associated with ready-to-eat foods (foods that do not receive a substantial heat treatment prior to consumption). Contamination of foods can occur at any point in the production, harvesting, processing or preparation of foods if handled by infected workers or food handlers, although the preparation step is probably the most common phase in which food handler contamination occurs.
How can Hepatitis A be controlled?
Hepatitis A virus cannot grow outside of the human host, thus time and temperature controls are not relevant. Control of Hepatitis A infection relies on prevention of contamination of the food through good sanitary practices, adequate personal hygiene and effective handwashing. Infected food workers must be excluded from handling food. Vaccines that provide immunity against hepatitis A are available. While the CDC suggests that vaccination protects against the spread of Hepatitis A virus, widespread vaccination of food handlers has not been recommended to-date, mostly because the disease is not common. Vaccination of handlers may be considered as a precautionary measure in areas that experience a Hepatitis A outbreak.
Reporting Hepatitis A:
Hepatitis A is a reportable disease in the United States and other countries. A doctor treating an infected individual or a retail establishment manager who is aware of an infected worker must contact the local health department. Food handlers should inform their managers if they contract or are otherwise exposed to Hepatitis A.
Contact us or visit Ecolab's microbial risk web pages for more information on Hepatitis A .
Here are additional resources for further information on Hepatitis A: