Vaccinating food service workers will not solve the entire HAV problem — we need a nationwide focus on homelessness and drug use as well.

According to a recent health warning, the CDC reported multiple states across the country have reported outbreaks of hepatitis A (HAV), primarily among people who use drugs and people experiencing homelessness. Since the hepatitis A outbreaks were first identified in 2016, more than 15,000 cases, 8,500 hospitalizations, and 140 deaths as a result of HAV infection have been reported.

The states’ data show about 65 percent of the individuals sickened have been linked to drug use and/or homelessness. The remaining 35 percent have been Epi-linked — people infected who are not drug users or homeless — or the cause of their infections is unknown.

In 2000, I said this:

“In the last six months Hepatitis A exposures have been linked to two Seattle-area Subways, a Carl’s Jr. in Spokane, WA, Hoggsbreath, a Minnesota restaurant, and three restaurants in Northwest Arkansas, IHOP, U.S. Pizza, and Belvedeers. Restaurants and food manufacturers must take action and voluntarily vaccinate all of their employees.”

Since then — especially recently — hardly a day goes by that the press does not report another food service worker possibly exposing thousands of patrons to HAV. Yet, neither the CDC nor any restaurant association has recommended HAV vaccination for such workers — until after the exposure. This is not an acceptable public health response.

What is Hepatitis A?
Hepatitis A is one of the five hepatitis viruses that are known to cause inflammation of the liver. The Centers for Disease Control and Prevention estimates that 150,000 people in the U.S. are infected each year by hepatitis. The illness is characterized by sudden onset of fever, malaise, nausea, anorexia, and abdominal pain, followed by jaundice. The incubation period for Hepatitis A, which varies from 10 to 50 days, is dependent upon the number of infectious particles consumed.

wher does Hepatitis A come from?
Hepatitis A spreads from the feces of infected people and can produce disease when individuals consume contaminated water or foods. Cold cuts, sandwiches, fruits, fruit juices, milk, milk products, vegetables, salads, shellfish, and iced drinks are also implicated in outbreaks. Water, shellfish, and salads are common sources. Contamination of foods by infected workers in food processing plants and restaurants is increasingly common.

How can a Hepatitis A infection be prevented?

• Get vaccinated.
• If exposed, the illness can be prevented by a shot of immune globulin or Hep A vaccine within two weeks of exposure.
• Wash hands thoroughly with soap and warm water after using the bathroom; changing diapers; and before preparing, serving or eating food.
• Clean and disinfect bathrooms and diaper-changing surfaces frequently.
• Never change diapers on eating or food preparation surfaces.
• Cook shellfish thoroughly before eating it.
• Drink water only from approved sources.

Editor’s note: People infected with Hepatitis A can pass the virus to others, as well as contaminate foods or beverages they handle, before they develop symptoms. Some infected people do not develop symptoms. These two facts make it even more important for foodservice workers and employees in the food industry to be vaccinated.