Humans can contract foodborne illnesses in a range of ways, including bacteria and viruses in undercooked or contaminated food. Common types of foodborne illness include infection with bacteria such as salmonella, E. coli or listeria. Viruses such as hepatitis A can also be acquired through eating contaminated food.
Food-related outbreaks of hepatitis A are usually associated with contamination of food during its preparation, by a food handler infected with hepatitis A. Symptoms do not occur for several weeks after exposure, and it is during this symptom-free time that a person is most contagious. Thus, an infected worker handling food would not yet have developed the illness themselves.
Symptoms of hepatitis A include: feeling tired and generally unwell, joint and muscle pain, fever, loss of appetite, feeling sick, pain in the liver area, yellowing of the skin and eyes (jaundice), dark urine and pale stools and itchy skin. According to the NHS, in most cases, hepatitis A will pass within two months, and there will be no long-term effects. For around one in seven people the symptoms may come and go for six months before disappearing. Rare life-threatening complications such as liver failure can occur, particularly in those with pre-existing liver problems and elderly people[i].
In the United States in 2017, clusters of hepatitis A appeared in several states, including 577 cases with 20 deaths in San Diego and 658 cases and 22 deaths in South East Michigan[ii]. In both of these clusters, the affected individuals included restaurant workers.
In the UK, hepatitis A vaccination is not routinely offered, because the risk of infection is low for most people. It is recommended for some high-risk groups, and for people planning to live in or travel to parts of the world where hepatitis A is more widespread.
In the United States, the Oakland County Michigan Health Department has hosted vaccination clinics for restaurant workers[iii]. The department recognizes restaurant workers as a priority target for the vaccination because they handle other people’s food and could unknowingly infect customers. Vaccination of restaurant workers will help to prevent them transmitting the virus, and could help restaurants reduce their risk of ill customers taking legal action.
[ii] Food service workers should be vaccinated against Hepatitis A. Food Safety News. 7 January 2018. http://www.foodsafetynews.com/2018/01/food-service-workers-should-be-vaccinated-against-hepatitis-a/#.WnUg2aNh1LU (Accessed 2 February 2018)