Hepatitis C In Food Service Workers

What Are The Symptoms Of Hepatitis A

The symptoms of hepatitis A may include an abrupt onset of fever, malaise, loss of appetite, nausea, stomach pain, dark-colored urine and jaundice . The disease is rarely fatal and most people recover in a few weeks without any complications. Adults have signs and symptoms of illness more often than children. Infants and young children tend to have very mild symptoms and are less likely to develop jaundice than are older children and adults. Not everyone who is infected will have all of the symptoms.

How Is Hepatitis A Diagnosed And Treated

The diagnosis of Hepatitis A involves detection of HAV specific IgM antibodies in the blood. It is detectable after 1-2 weeks of exposure by HAV and is present for up to 14 weeks. The presence of these antibodies indicates that the acute stage of illness is now over, and the person has become immune to other infection.

The medical and general treatment for Hepatitis A involves:

• rest
• avoiding alcohol to reduce strain on liver
• practicing good hygiene

Anyone who suspects that they may have contracted Hepatitis A should see their doctor if they have any of the symptoms mentioned above of Hepatitis. A visit to the doctor may also be a good idea if someone has traveled to a country where Hepatitis A is common or has been to a restaurant and eaten a meal that linked to a Hepatitis A outbreak.

If the exposure period is still within the first 2 weeks, a post-exposure vaccine can be given as another form of treatment.

How Does It Affect Our Body

Symptoms start appearing after 2-6 weeks of exposure, sometimes even up to 7 weeks after. Symptoms usually last for less than 2 months. But some people can suffer from the symptoms of Hepatitis A for as long as 6 months.

Symptoms of Hepatitis A include:

• Jaundice
• Joint pain and Muscle Pain
• High Temperature
• Itchy Skin
• Pain in upper part of the abdomen

About 10-15% of those infected may have a recurrence in the symptoms during the 6 months after the initial infection.

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We Can Help Your Employer Or Team Understand More About Hep C

There are many misconceptions around hep C and how it is transmitted. If your workplace would like to know more about hep C, sign up for one of our FREE Workforce Education programs.

One of our experienced and qualified trainers will deliver a tailored workshop to your team, which will help your colleagues understand more about hep C.

How To Reduce The Risks

If a worker or workers could be exposed to Hepatitis, the employer must develop and implement an exposure control plan . This plan must identify the workers at risk of exposure and the controls required to protect those workers. These will be unique to each worksite and work environment. When choosing risk controls, start by asking yourself the questions in the following steps, listed in order of effectiveness. See our resources for more information.

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Foodservice Workers Should Be Vaccinated Against Hepatitis A

Hepatitis A is a communicable disease that often spreads from person to person. Person-to-person transmission occurs via the fecal-oral route, while all other exposure is generally attributable to contaminated food or water. Food-related outbreaks are usually associated with contamination of food during preparation by a hepatitis A infected food handler. The food handler is generally not ill because the peak time of infectivity that is, when the most virus is present in the stool of an infected individual occurs two weeks before illness begins. Hepatitis A symptoms may not occur for several weeks after exposure and may include abdominal discomfort, fever, malaise, muscle aches, and a yellowing of the skin called jaundice. In rare cases, hepatitis A causes liver failure and death.

In 2017 San Diego saw at least 577 illness with 20 deaths and 396 hospitalizations some of those illnesses have spread to local restaurants workers. We also saw clusters of hepatitis A illnesses spreading to other parts of California as well as Utah, Kentucky, New York and Hawaii, and there are likely other less reported hepatitis A illnesses. The largest outbreak that has also spread to restaurant workers is in South East Michigan where the total number is 658 illnesses with 22 deaths.

All of this is preventable by a vaccine.

Retail Restaurant And Travel Foods

Meat, poultry products, and shell fish are significantly considered as the vehicles for the transmission of foodborne diseases , which often occur from retail shops, restaurants, and travel foods made from contaminated raw foods, cross contamination during processing and storage, insufficient cooking, inadequate cooling, a lapse of > 12 h between cooking and eating, improper handling by consumers or by infected food service workers, and container leakages increases the incidents of outbreaks . Studies revealed that different types of pathogens such as Salmonellas, E. coli, Campylobacter jejuni, Clostridium perfringens, Shigella, Staphylococcus, Listeria monocytogenes are often found in fresh meat and poultry products, which are most common in almost all retail shops and restaurants. Salmonella, Plesiomonas shigelloides, and Staphylococcus are also found in various types of shellfish like raw shrimp or crab meat while Vibrio gastroenteritis is the most commonly found pathogen in raw oysters . Diseases due to these pathogenic microbes can cause serious, and sometimes fatal complications that make the immune-compromised patients, pregnant women and children vulnerable. Symptoms include bloody diarrhea, severe abdominal pain, hemolytic uremic syndrome , neurological disorders, long-term illness, and hospitalization .

John N. Sofos, in, 2014

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Sharing Toothbrushes Scissors And Razors

There’s a potential risk that hepatitis C may be passed on through sharing items such as toothbrushes, razors and scissors, as they can become contaminated with infected blood.

Equipment used by hairdressers, such as scissors and clippers, can pose a risk if it has been contaminated with infected blood and not sterilised or cleaned between customers. However, most salons operate to high standards, so this risk is low.

For How Long Is An Infected Person Able To Spread The Virus

The contagious period begins one to two weeks before symptoms appear, and is minimal about one week after the onset of jaundice. Food workers should be excluded from work for at least two weeks after the onset of clinical symptoms of hepatitis A. If jaundiced, food workers should not return to work for at least one week after onset of jaundice.

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How Does Hepatitis C Spread

Hepatitis C is spread only through exposure to an infected person’s blood.

High-risk activities include:

• Sharing drug use equipment. Anything involved with injecting street drugs, from syringes, to needles, to tourniquets, can have small amounts of blood on it that can transmit hepatitis C. Pipes and straws to smoke or snort drugs can have blood on them from cracked lips or nosebleeds. Get into a treatment program if you can. At the very least, don’t share needles or equipment with anyone else.
• Sharing tattoo or piercing tools. Nonsterile items and ink can spread contaminated blood.
• Blood transfusions in countries that donât screen blood for hepatitis C.
• Nonsterile medical equipment. Tools that arenât cleaned properly between use can spread the virus.
• Blood or cutting rituals. Sharing the tools or exchanging blood can transmit hepatitis C.

Medium-risk activities include:

What Are The Chances Of Getting Hepatitis C From Sex

Hepatitis C can spread through sexual intercourse, but it’s rare. And it’s extremely rare among monogamous couples. In fact, the CDC considers the risk of sexual transmission between monogamous couples so low that it doesn’t even recommend using condoms. Also, there’s no evidence that hepatitis C is spread by oral sex. But you should avoid sharing razors, toothbrushes, and nail clippers, and sex during menstruation.

If you have HIV or if you have multiple partners, you should take precautions. Using condoms will protect you and your partners.

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How Can Hepatitis A Be Prevented

To prevent person-to-person spread, careful hand washing after using the bathroom, changing diapers and before preparing or eating food, is the single most important means of prevention.

Foodborne hepatitis A outbreaks are relatively uncommon in the United States however, when they occur, intensive public health efforts are required for their control. To prevent the spread of hepatitis A from an infected food worker to co-workers and/or restaurant patrons, food workers should never touch ready-to-eat foods with bare hands, and should carefully wash their hands after using the bathroom, even if the food worker does not feel sick. Food workers should never work while they are sick with stomach illnesses.

Immune globulin shots are effective in preventing the spread of hepatitis A if given within 14 days of exposure. Immune globulin may be recommended for co-workers of infected food workers. Under certain circumstances, particularly when recommended food safety procedures are not followed by food workers, public health officials may recommend that restaurant patrons receive immune globulin.

For long-term protection, hepatitis A vaccine is the best method of prevention.

What Is Hepatitis C

Hepatitis C is a serious liver infection caused by the hepatitis C virus . It is a chronic illness . If you have hepatitis C, you need to be monitored carefully by a doctor because it can lead to cirrhosis and liver cancer. Cirrhosis from hepatitis C is a leading cause of liver failure and someone who has it may need a liver transplant. Most people who are infected with hepatitis C dont experience any symptoms for years. The symptoms may gradually develop and may include

• Lack of appetite
• Abdominal tenderness on the area over your liver

As the disease progresses, hepatitis C can cause liver damage. In many cases, there are no symptoms until liver problems develop. If symptoms of liver problems do appear, they may include

• Jaundice
• Low-grade fever

Treatment of hepatitis C

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Liability In A Hepatitis A Case

If your Hepatitis A was caused by improper food handling, serving, storing, or manufacturing, the parties responsible may be liable for any damages. Any individual or entity in a contaminated food products chain of distribution can potentially be held accountable. The types of parties commonly named as defendants in Hepatitis A cases are restaurants, food suppliers, manufacturers, processors, and distributors. An attorney can help you determine which parties can be held legally responsible and the legal theories to base your claim on. Hepatitis A lawsuits are commonly brought under the theory of negligence, strict liability, or breach of warranty.

Hepatitis And Food Service Jobs Know Your Abcs

From the desk of Linda Carter Batiste, J.D., Principal Consultant/Legislative Specialist

Employers who contact JAN with questions regarding hepatitis and food service jobs tend to mainly be concerned about the danger of spreading the disease, what medical questions they can ask about hepatitis, and whether they can tell coworkers when an employee discloses hepatitis. Our answers to these questions often start with the same statement: it depends on what type of hepatitis the person has. Why does this matter? There are three main types of hepatitis: A, B, and C. However, only one type is spread through contaminated food and thats hepatitis A.

Luckily, many of the questions we receive about hepatitis A and food service jobs are addressed in a publication from the Equal Employment Opportunity Commission called How to Comply with the Americans with Disabilities Act: A Guide for Restaurants and Other Food Service Employers. The following answers are based on information contained in this publication.

Can a person with hepatitis A be denied a food service job based on safety concerns without violating the Americans with Disabilities Act ?

What questions can food service employers ask about hepatitis A and when can these questions be asked?

Under the ADA there are different rules about asking medical questions depending on the stage of employment.

Can an employer tell other employees that a specific employee has been diagnosed with hepatitis A?

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Dishing Up Hep A: Should Food Workers Be Vaccinated

The sushi was delicious, as far as Luther Smith remembers. It was only later, after he developed hepatitis A spread by an infected food handler, that the Harlem, N.Y., man was left with far more than a bad taste in his mouth.

I was shivering. I was achy. I felt like something was wrong, but I didnt know what, recalls Smith, 51, one of four people who contracted the dangerous liver disease last year at the now-defunct New Hawaii Sea restaurant in the Bronx.

Then my wife looked at me and said: The whites of your eyes are becoming yellow.

Smith, like most American diners, didnt know that the hepatitis A virus is highly contagious and spread when people use the toilet and then fail to properly wash their hands. And he didnt know that in most places across the U.S., theres no requirement that kitchen workers receive the vaccination that can prevent infection in the first place.

I couldnt believe it, said Smith, whose wife and mother-in-law also contracted the virus. If you work in a kitchen and you have exposure to food and youre handling raw food, it makes sense that, you know, youre going to get your people vaccinated.

The question of whether hepatitis A inoculations should be mandatory for food workers or whether the cost to business isnt worth the wider benefit is gaining renewed attention from federal regulators, health officials and ordinary consumers amid a spate of new restaurant warnings.

The cost savings go beyond the price of the shots, she said.

When Do You Need To Tell Work About Your Hep C

If you find you have hep C, the only times you need to tell your work about your hep C is:

• If you are a health care worker who performs exposure-prone procedures and who is PCR positive. If this is the case, you have a responsibility to disclose this to HR or your manager.
• If you are employed in the Australian Defence Force

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How Can A Hepatitis A Attorney Help My Case

A Hepatitis A attorney understands the challenges of food poisoning lawsuits and can carefully prepare your case to meet them head-on. Tracing Hepatitis A to a specific cause is challenging since evidence starts to break down almost immediately. Symptoms might not appear for weeks, and in the meantime, you will have eaten other foods. An attorney has the resources to conduct an in-depth investigation and access to the medical experts, consultants, and scientific testimony needed to prove your claim.

There may be multiple liable parties, and some of the defendants may be powerful. For instance, in a case involving a chain restaurant, the defendant will likely have an entire team of attorneys and vast financial resources. A lawyer who regularly handles food safety cases will not be intimidated and will know what to do to obtain the compensation you deserve.

How Do I Avoid Getting Sick

These tips will help protect you and your family from Hepatitis A:

• Wash your hands after using the washroom and changing diapers, and before preparing or eating food.
• When travelling, especially to developing countries:
• drink water from a safe supply
• avoid ice cubes in drinks
• eat only freshly cooked food
• avoid non-peelable raw fruit or vegetables

Also, these safe food practices will reduce your risk of contracting Hepatitis A and other foodborne illnesses.

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How Hepatitis A Spreads

HAV infection is a fecal-oral disease. This means the virus is transmitted via somethingoften food or water that has been contaminated with fecal matter from an infected person.

Chefs, cooks, line prep workers, and other restaurant workers with HAV infection who do not thoroughly wash their hands and put on fresh disposable gloves after using the bathroom can easily pass the virus onto food, dishes, utensils, and other surfaces touched and ingested by patrons.

The hepatitis A virus is especially infectious because it can live for up to four hours on fingers and hands and for several days in water.

Core Values Of Public Health

The World Health Organization Code of Ethics and Professional Conduct focuses on broad ethical principles such as integrity, accountability, independence and impartiality, respect, and professional commitment and ensuring a fair and respectful workplace . Public health professionals must carefully analyze regulations that mandate vaccinations for a specific group of workers. The American Public Health Association Public Health Code of Ethics set forth four components necessary for four components if ethical analysis of a public health issue . These include:

• identifying public health goals

• analyzing implications for the health and rights of all stakeholders, and

• determining if the action fits with core values of public health

The core values of public health practice, further elaborated in the APHA document, include safety, justice, equity, civil liberties, solidarity, and inclusivity, underlie ethical decision making in public health. In addition, the APHA advocates considering effectiveness, responsible use of scarce resources, proportionality, accountability, and public engagement . The following sections discuss each of the four components described in the APHA Public Health Code of Ethics to provide guidance for regulations in the US and globally.

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