The Alphabet Soup of Hepatitis and Why it Should Concern Foodservice Operators.

Late in July, I was made aware that World Hepatitis Day was on July 28th.  I do have to be honest – similar to most of you reading this, I was surprised there was such a thing.  After doing a bit of research, I discovered July 28th was named as such to recognize the birthday of Dr. Baruch Blumberg, who first discovered the hepatitis B virus in 1967 and then two years later developed the first hepatitis B vaccine.  Each year, the Centers for Disease Control and Prevention and the World Health Organization recognize the day to help raise awareness about hepatitis, which impacts over 300 million across the globe and causes more than one million deaths a year.

As I am sure many of you remember from your first food safety class, hepatitis A is associated with safe food handling.  While I am sure many of you have heard of hepatitis A, B, and C, we do not often hear about hepatitis D and E in the United States.  When a case of hepatitis D or E is discovered, in most cases it involves an individual who has traveled to developing countries where the water supply is not well developed and there is poor environmental sanitation.

Hepatitis means inflammation of the liver and this inflammation can be caused by several things: drugs, alcohol, medical conditions, or most commonly, viruses.  Thus, hepatitis A, B, and C are all distinct viruses that impact the liver. Each has a different set of symptoms and treatments, but I wanted to focus mostly on hepatitis A, because it is the most likely to impact a foodservice operation.[/vc_column_text][vc_separator][vc_column_text css_animation=”rotateInDownLeft”]

From 2013-2018, 72% of all illnesses, 67% of all hospitalizations, and 100% of all deaths related to hepatitis A in the United States were traced back to a foodservice operation. 

[/vc_column_text][vc_separator][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]After several years of decreasing hepatitis A incidences, around 2012 the rate began to increase.  Substantial increases occurred in 2017 and 2018, and while they were traced back to those who used drugs, sex, and lack general sanitation, a portion of these outbreaks were associated with food. Data pulled from the National Outbreak Reporting System revealed there were 21 outbreaks related to food in the last five years for which data was available (2013-2018), yielding 724 illnesses, 259 hospitalizations, and five deaths. When you start to explore this data to see the role foodservice operations played in this, it is interesting to note that 81% of the outbreaks were traced back to a foodservice operation. Those operations accounted for 72% of all illnesses, 67% of all hospitalizations, and 100% of all deaths associated with hepatitis A transmitted through food.

Recent outbreaks have been linked to fresh blackberries, frozen strawberries, raw scallops, and pomegranate seeds. However, it is important to note the type of food is not the key ingredient in transmission, rather how that food was handled is the most important aspect.  Contamination can happen at any point in the food chain from growing to harvesting, or from processing to handling.  Contamination can occur even after cooking is completed.  Much like we have come to learn about Coronavirus, food handlers can spread hepatitis even if they show no symptoms and can transmit the virus up to two weeks before symptoms appear.

To prevent spreading the virus, food handlers should never touch ready-to-eat foods with bare hands. It is also critical to thoroughly wash their hands after using the bathroom or changing diapers (those of you in childcare settings), even if the employee does not feel sick. Of course, employees should never work while they are experiencing a gastrointestinal illness.

It all seems so simply, right?  Yet, we have an increasing number of outbreaks each year in the US.  So, take a few moments early this month to remind your staff and co-workers about hepatitis A and why it is so vital that the do the simple things – wash your hands thoroughly, use barriers when handling ready-to-eat foods, and stay home when you are not feeling well (something I am sure they have heard a lot about in the last 20 months).