Editor’s note: May is Hepatitis Awareness Month and today is Hepatitis Testing Day. For more information, click here to visit the CDC page.

I am sure the idiom, “you sound like a broken record,” is a bit unfamiliar to those 40 and younger, but it means repeating yourself again and again and again.  So, here I go again – “Restaurant workers should be vaccinated to combat spread of hepatitis A.”  Some restaurants are getting the message – although, generally after an infectious episode.

This month the CDC reported that since March 2017, CDC’s Division of Viral Hepatitis (DVH) has been assisting multiple state and local health departments with hepatitis A outbreaks, spread through person-to-person contact.  Since the hepatitis A outbreaks were first identified in 2016, more than 17,000 cases reported and at least 170 deaths as a result of hepatitis A virus (HAV) infection have been reported.

Just in the past week three unvaccinated hepatitis A infected food service workers exposed hundreds to the virus.

Florida: The Florida Department of Health in Sarasota County said the employee, a part-time dishwasher at Duval’s seafood restaurant at 1435 Main St., may have exposed people who ate or drank at the restaurant between April 26 and May 10. Shortly after the employee tested positive for the virus, the restaurant had all of its staff members vaccinated for hepatitis A. The restaurant will make the vaccine mandatory for all new employees, Abrams said. DOH Sarasota is offering the hepatitis A vaccine for free at its Sarasota and North Port Immunization Clinics. The Sarasota office at 2200 Ringling Blvd. will be open Sunday from 9-11 a.m. to administer vaccines.

Maine: Health officials are recommending Hepatitis A vaccinations for some customers and workers at a Burger Boy restaurant in northern Maine. The Maine Center for Disease Control and Prevention says an employee at the Caribou restaurant had an acute case of the contagious liver disease while preparing food in late April and the first two weeks of May. Because the virus can spread through food or water, officials are recommending vaccination for anyone who ate or worked there between May 3 and May 13.

Massachusetts: Massachusetts health officials say a seafood restaurant worker has tested positive for hepatitis A and are warning customers they may have been exposed to the disease. The state Department of Public Health and local health officials are urging customers who ate cold or uncooked food at Roy Moore’s Fish Shack in Rockport between April 21 and May 12 to contact their health care providers and receive treatment for possible exposure to hepatitis A. A posting on the restaurant’s Facebook page on Saturday said the restaurant has temporarily closed for disinfecting and to ensure no other workers have the disease.

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

The CDC 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.

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.

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.

Where 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.

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