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).
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Foodborne Illness Myths & Facts
“It must have been something I ate.” That’s the typical statement when a person develops some relatively minor symptoms from food. Maybe not severe enough to go to the doctor so you choose to tough it out without medical care. Sudden onset of flu-like symptoms such as onset of stomach cramps, diarrhea, vomiting and fever could possibly mean you are the victim of a foodborne illness. The illness is sometimes referred to as “food poisoning”, but it’s often misdiagnosed.
Don’t Compromise: Clean and Sanitize
The subject is cleaning and sanitizing. Chefs, food service directors, managers and staff try to practice safe food-handling at every turn in the kitchen. Don’t let that effort go down the drain by slacking off on the many aspects of sanitation. That includes dish and ware-washing techniques (pots, pans, equipment), and cleaning all the areas that give us that “neat as a pin” appearance in your customers eyes. Customers seldom fail to bring that soiled silverware or glass with lipstick on it to the attention of the manager or wait staff. Improperly cleaning and sanitizing of food contact equipment does allow transmission of pathogenic microorganisms to food and ultimately our customer.
The Route to Safer Fresh Fruits and Vegetables
Although fruits and vegetables are one of the healthiest foods sources in our diet, we continue to have foodborne disease outbreaks of significance from produce, sometimes affecting large groups of people in multiple states because of their wide distribution. The CDC estimates that fresh produce now causes a huge number of foodborne illness outbreaks in the United States. Produce needs our continued food safety efforts at the restaurant level as well as at the stages in agricultural production. Occasionally, fresh fruits and vegetables can become contaminated with harmful bacteria or viruses, such as Salmonella, E. coli 0157:H7, Norovirus, and Hepatitis A. This contamination can occur at any point from the field to our table. If eaten, contaminated fruits and vegetables can cause foodborne illness.
Be Cool, Chill Out, Refrigerate Promptly!
The Cold Chain -- Keeping perishable foods at proper cold holding temperatures (between 28°F and 41°F maximum or 0°F for frozen food) from your food producers / manufacturers to your customers has to be one of our strongest links to safe food and high quality. Sometimes that is referred to in the food industry as “maintaining the COLD CHAIN”. Any slip ups in the cold chain, and we have a weak link. Most all of our state food regulations require 41°F as a cold maximum, but colder is a “best practice” policy to maintain.
