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What is hepatitis A?
Hepatitis A is a virus that causes liver disease. The disease is mild in
children, but can be more severe in adults and can cause infected
individuals to miss up to 6 weeks of work.
What are the symptoms of hepatitis A?
Symptoms often appear about one month after infection, but can develop
anytime between 2 to 6 weeks after infection. Infected persons may
experience fever, extreme weakness, loss of appetite, nausea, vomiting,
stomach cramps, and diarrhea. These symptoms are usually followed by a
few days of dark, "tea-colored" urine and jaundice (yellow skin and
eyes).
How is hepatitis A spread?
The hepatitis A virus is found in the feces (stool) of infected persons.
Hepatitis A virus is not spread through blood, but is spread primarily
though the fecal-oral route. Infected food handlers may carry the virus
on their hands and may contaminate ready-to-eat food when they do not
use good handwashing practices after every restroom visit and have bare
hand contact with ready-to-eat food. For the disease to spread, the
virus must enter the mouth of a person who has not had hepatitis a
before or is not immunized against hepatitis A. Good handwahsing
after toileting and no bare hand contact with ready-to-eat food can
greatly reduce the spread of hepatitis A from an infected food handler
to others.
How long can an infected person spread hepatitis A?
An infected person can spread the virus for 1 to 2 weeks before symptoms
start and up to 10 days after jaundice. Therefore, an infected person
may potentially shed hepatitis A virus for almost one month.What
is the treatment for hepatitis A?
There is no specific treatment for hepatitis A. Bed rest and avoiding
alcohol, drugs, and over-the-counter medicines is recommended for a
faster recovery. Once recovered, a person cannot spread the disease
further, is immune for life and cannot be infected with hepatitis A
again.
Are food handlers at higher risk for hepatitis A?
Food handlers are not at higher risk than other persons for becoming
infected with hepatitis A. However, infected food handlers are at higher
public health risk for spreading hepatitis A to others. Food
handlers have the potential to infect hundreds of people if they work
while infected with hepatitis A, do not use good handwashing techniques,
and have bare hand contact with ready-to-eat food.
What should be done if a food handler is experiencing symptoms of
hepatitis A?
If a food handler is experiencing symptoms of hepatitis A, the food
handler should be excluded from food handling immediately, should seek
medical care, and should not return to food handling until 2 weeks after
the beginning of the illness.
What should be done for co-workers of a food handler infected with
hepatitis A?
Co-workers who worked the same days and shifts of a food handler
infected with hepatitis A should not be allowed to handle food until
they receive a shot of immune globulin (IG) to help prevent hepatitis A
or show proof of previous infection or previous vaccination. The
co-workers may return to food handling if they receive IG or provide
proof of immunity and are not experiencing any symptoms. If the
co-workers refuse IG, they are not allowed to handle food for 50 days
starting from their last contact to the infected food handler during the
time when the food handler was still contagious.
If a person receives Immune globulin (IG), is this person immune
for life?
No. IG protects a person who has not been infected with hepatitis A for
up to 3 months. IG provides protection if it is given before exposure to
the hepatitis A virus or if it is given within 14 days of
exposure to the virus. However, getting IG does not guarantee complete
protection against hepatitis A, especially if a person has been exposed
the virus multiple times. IG may make the symptoms milder in a person
already infected with hepatitis A.
Are there any health regulations for food handlers infected with
hepatitis A?
Yes. To protect the public's health, food handlers infected with
hepatitis A cannot handle food until 2 weeks after they started having
symptoms. (K.A.R. 28-1-6). All food handlers should also follow the
Kansas Food Code 3-301.11, which prohibits bare hand contact with
ready-to-eat food by any food worker.
What are the potential consequences of a food handler who works
while infected with hepatitis A?
A food handler who works while infected with hepatitis A has the
potential to infect hundreds of customers who have eaten food prepared
by the infected worker. The risk of spreading the hepatitis A virus and
other diseases increases if the infected food handler has bare hand
contact with ready-to-eat food and does not wash his/her hands properly
after toileting. When customers have eaten food prepared by a worker
infected with hepatitis A, the media is often the most efficient way of
informing customers of their possible risk of and treatment options for
infection with hepatitis A. This customer recall may affect a
restaurant's business, reputation, and financial stability.
How can food handlers prevent the spread of hepatitis A?
Food handlers should never work while ill with fever, nausea, vomiting,
stomach cramps, or diarrhea. If a food handler is experiencing any of
these symptoms, he/she should immediately stop working, inform the
manager, and seek medical care.
Food handlers should always use good handwashing techniques,
especially after using the restroom. The proper handwashing method is
the following:
- use soap and warm, running water;
- rub hands together vigorously for 20 seconds;
- wash all surfaces, including backs of hands, wrists, between
fingers, tips of fingers, under fingernails;
- rinse hands well; and
- dry hands with a paper towel, if possible.
Food handlers should not have bare hand contact with ready-to-eat
food. If gloves are used, hands must be washed before putting on gloves.
Gloves should be used for only one task and then discarded. Gloves
should also be replaced with clean gloves whenever food preparation has
been interrupted.
NOTE: Glove usage does not replace the need for good handwashing
practices.
A vaccine that protects against hepatitis A virus is available and
can be used to prevent infection in food handlers.
Is there a vaccine that protects against hepatitis A?
Yes. The hepatitis A vaccine was licensed in the U.S. in June 1995 and
is safe and effective for the prevention of hepatitis A. The vaccine is
a two-dose series, with the second dose given 6 to 12 months after the
first dose. Nearly everyone is protected one month after receiving the
first dose, but a second vaccine is given for lifelong protection.
Source: Kansas Department of Health and Environment
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