America’s food safety attorney Bill Marler, who by way of proper disclosure is also the publisher of Food Safety News, wants food handlers vaccinated for Hepatitis A.

Fact is Marler has been on something of a campaign or crusade or jihad with health departments and restaurant owners to get food handlers vaccinated.

He’s pleaded, cajoled, and bargained with the restaurant industry, even offering not to sue the first restaurant chain that promises to keep its staff vaccinated against the viral liver disease that has reached epidemic levels in areas of the United States.

The restaurant industry has mostly ignored Marler on the issue, but there are signs of change coming through health departments.

In Virginia, where health authorities confirmed 191 cases of Hepatitis A with 116 or 61 percent requiring hospitalization, the Mount Rogers Health Department recently met with 400 restaurant employees in the area of the state most impacted by Hepatitis A.

Its goal was to persuade restaurant owners and their employees to get vaccinated. Dr. Karen Shelton, Mount Rogers director, says food handlers are not necessarily at increased risk of getting Hepatitis A.

However, when they do get infected, there is a higher risk of food handlers spreading the virus because their job is preparing food for other people to eat.

Shelton met with more than 400 restaurants in Bristol, VA, and Washington and Smyth counties, the area with the most significant incidences Hepatitis A in the state. The education campaign also urged restaurant workers to wear gloves and owners to adopt return-to-work policies.

Hepatitis A is going viral at various locations throughout the U.S. During the past three years, CDC has confirmed 26,789 cases of Hepatitis A with 16,157 or 60 percent requiring hospitalization. And the death count has reached 274. The figures are current as of Oct. 4.

“OK, I know I am becoming a broken record, but we see food service workers with hepatitis A on a near-daily basis exposing thousands to hepatitis A – why not vaccinate them and prevent the spread?” Marler asked on his blog on Oct. 7.

Marler knows about which he writes.

“Hepatitis A is a contagious liver disease that causes fever, nausea, diarrhea, vomiting, jaundice (yellowing of the skin or eyes) and abdominal pain, and dark-colored urine, ” his blog says. “Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool (feces) from an infected person.”

While pounding the drum to get food service workers vaccinated, Marler has also shared the “official word” on the subject with his readers.

:”However,” he recently wrote, “according to the CDC, the Advisory Committee on Immunization Practices continues to recommend only that the following persons be vaccinated against hepatitis A:

  • All children at age 1 year;
  • People with unstable housing or experiencing homelessness;
  • Persons who are at increased risk for infection;
  • Persons who are at increased risk for complications from hepatitis A; and
  • Any person wishing to obtain immunity.

“Which groups do not need routine vaccination against hepatitis A?” according to the CDC:

  • Foodservice workers. Foodborne hepatitis A outbreaks are relatively uncommon in the United States; however, when they occur, intensive public health efforts are required for their control.
  • Although persons who work as food handlers have a critical role in common-source foodborne outbreaks, they are not at increased risk for hepatitis A because of their occupation. Consideration may be given to vaccination of employees who work in areas where community-wide outbreaks are occurring and where state and local health authorities or private employers determine that such vaccination is cost-effective.”

The Advisory Committee’s recommendations are based on the fact that most Hepatitis A is spread person-to-person and only some by food and beverages. But as Marler is known to report, there’s been an endless string of infected foodservice workers reporting for duty and potentially exposing hundreds of customers to the virus.    Usually, the restaurant or health department then offers the vaccination to all those who were exposed to the worker.

The National Restaurant Association reports that 15.2 million are employed by the restaurant industry which has more than one million locations. At $100 a vaccine, getting all restaurant workers vaccinated might cost taxpayers or employers $1.5 billion.

But the good news that new restaurant employees are increasingly likely to already be vaccinated for Hepatitis A.  That’s because the 2-dose vaccine for children under two years of age was first licensed in 1995, and become common about a decade later.  In 2006, only 1 percent of two-year-olds were vaccinated. By 2009, that percentage was up to 15 percent.  Coverage has increased every year since.

Because two-year-olds have been vaccinated for Hepatitis A for a dozen years or more, we are close to the time when most entering the restaurant industry will be vaccinated when they first arrive on the job.

In the meantime, vaccinating restaurant employees in these hotspots for Hepatitis A is probably a pretty good strategy.

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