By: Heather Williams

We put quite a bit of trust in those who make and handle our food.  For the most part, things go as they should.  Workers follow safe handling procedures.  Restaurant management acquires ingredients from safe, trusted sources.  Food is cooked to appropriate internal temperatures.

But sometimes things don’t go as planned.  Sometimes mistakes behind the kitchen doors can have serious consequences.  One such mistake at an Alabama pizza shop has had consequences including exposure to the serious virus Hepatitis A and requiring exposed patrons to seek medical care and vaccination.

If Affected, Take Action and Get Vaccinated

A food handler at Marco’s Pizza in Anniston Alabama has been diagnosed with hepatitis A, according to Alabama Public Health.  The health department is urging those who consumed food from the restaurant between September 26, 2017 and October 2, 2017 to be vaccinated against the virus.  This applies to dine in, pickup, and delivery.  Unfortunately, if you consumed food prepared prior to September 28, 2017 it is too late to receive the vaccination.  The vaccine is only effective at preventing viral infection after exposure if given within two weeks of exposure to the virus.  Those who were exposed prior to September 28, 2017 should consult with their health care professional.

For those wishing to be vaccinated, your health care provider can help you determine if you should receive the hepatitis A or immune globulin vaccination.  Age and other factors must be considered to determine which one is appropriate for you.  Generally, for people 12 months to 40 years old that have never been vaccinated will receive the hepatitis A vaccine.  Those over the age of 40 are often given the immune globulin vaccination

How to Know if You are Infected

The Hepatitis A virus affects the liver and can be spread though consuming contaminated food and drink as well as person-to-person contact.  It is important to stay home from school, work, or activities where you are in close quarters with others if you are sick, particularly with hepatitis A or a diarrheal illness to prevent the spread of illness.  Those who are infected with hepatitis A may not even know they are infected for up to two weeks.  It often takes 14 days for symptoms to appear.  If possible, those who have jobs in which they interact with the public should get vaccinated to prevent infection and prohibit the spread of infection.  If you have been vaccinated or have already had the virus, you are protected from the illness.

For those with a healthy immune system, symptoms of hepatitis A infection may be mild.  Dr. Burnestine Taylor, Medical Officer for Disease Control and Prevention, ADPH said in a statement, “Adults with hepatitis A may have symptoms that include fatigue, low appetite, stomach pain, nausea, and jaundice. These symptoms usually resolve within two months of infection. Children less than 6 years of age generally do not have symptoms or have an unrecognized infection. Almost all people who get hepatitis A recover completely.”

In general, symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice (yellowing of the skin and eyes).

The average incubation period of hepatitis A virus is 28 days, with a range of 15 to 50 days.  The virus can live outside of the body for months depending on the environmental conditions.

For those with a compromised immune system, as well as those over 50 years old, and individuals with existing liver disease may experience serious illness, possibly leading to death.

Why Vaccinate?

Statistically, cases of hepatitis A have declined in the United States since the introduction of the hepatitis A vaccine.  This 95% decline since 1995 is significant.  The vaccine is making an epidemiological impact, in a good way.

Don’t wait until you are exposed.  If you are not already vaccinated, you can do so at any time.  In fact, the CDC urges children over the age of 1 year to be vaccinated.  You should be vaccinated if you are someone who has a higher risk for infection or someone who may have a higher risk for complication from hepatitis A.

Who Has a Higher Risk of Infection?

Some people engage in activities or work that leaves them a higher risk for infection.  Others have pre-existing health problems which may contribute to a higher risk of infection.  These categories are as follows:

  • If you travel to, or work in particular countries known to have intermediate or high endemic rates of hepatitis A you have a higher risk of infection.
  • Sexual transmission through anal sex is a common mode of transmission of hepatitis A infection.
  • If you work in an occupation with a higher risk of infection, such as working directly with the virus in infected primates or with the virus in a laboratory setting, you are at increased risk due to occupational exposure.
  • Those with chronic liver disease are at a higher risk of becoming infected. These individuals are most likely to have rapid onset of liver failure, which can lead to death.
  • Individuals with clotting-factor disorders are also at a higher risk for becoming infected. Those who are administered clotting-factor concentrate in particular are at a higher risk of infection.
  • If you are in direct contact with someone who has been recently exposed the virus, you are at a higher risk for infection. You may be at risk, even if no symptoms are present in the infected person at this time.

How Can I Kill Hepatitis A in the Environment?

If hepatitis A can be spread through food and drink, how can the virus be killed so it cannot infect someone?  The answer is cooking to a temperature of at least 185 degrees F for one minute.  Cooked food can still be contaminated if it comes in contact with someone who is infected after the food has been heated.  Note that freezing contaminated foods does not inactivate the virus.  Chlorination of water supply is another way to kill the virus.  Due to the fact that there is no statistically significant different between typical Americans and those who have worked in sewage, it is unlikely to suspect that sewage has a higher transmission rate.  Hepatitis A found in the household environment can typically be killed with a freshly prepared solution of 1 to 100 household bleach to water.

To protect yourself and the spread of the virus, wash hands thoroughly before eating and after going to the bathroom.  Be sure to self-report if you feel you may be contaminated and become ill.   If you are taking care of someone who is ill, use extra hygiene caution to avoid contracting and further spreading the virus.