Just a few years ago, hepatitis A was a disease that seldom made headlines in our nation. There were rare cases of an infected restaurant worker passing the disease on to patrons. People knew that vaccination might be needed for travel to certain countries where the disease was more common.
Other than that, the U.S. Centers for Disease Control and Prevention didn’t – and doesn’t -- recommend the vaccine for most adults. The main exceptions are people with liver diseases, for whom hepatitis A could be a more serious illness, men who have sex with other men, and users of illegal drugs, who are at higher risk. Babies already are supposed to be vaccinated, though the vaccine can be given at any age after that as well.
Now it seems that hepatitis A outbreaks are in the news every week – so much so that vaccines are sometimes in short supply. And though few of the cases involve restaurants, there is new interest in the idea of vaccinating more food workers.
In other words, current events make this an especially worthwhile year to ponder what World Hepatitis Day, on Saturday, July 28, should mean in terms of using vaccination to prevent future problems to the extent possible.
The recent issues began with a persistent outbreak that began late in 2016 among the homeless population of San Diego, California. The city was recently faulted in a grand jury report saying that officials did not move quickly enough to sanitize the areas where homeless people lived. It did, however, provide vaccinations to 100,000 people, NBC in San Diego reported, and the outbreak died out this past January. Before that happened, though, the disease sickened close to 600 people and killed 20 of them.
The reports of hepatitis A spread to Colorado, Utah, Kentucky, New York, Indiana, West Virginia and Hawaii, among others. It’s believed that much of the spread to other states came from San Diego. The disease is transmitted by contact with even microscopic amounts of infected fecal matter.
In some states, such as California, the homeless population has been particularly vulnerable; homeless people generally live in unsanitary conditions without facilities for personal hygiene. Soap and water is needed for hand-washing; hand sanitizers aren’t effective. In West Virginia, the outbreak has stricken mostly users of street drugs. But in some areas of the nation, the disease has spread to restaurant workers, who can then spread it to customers, especially if the employees don’t follow proper handwashing procedures. Workers at several restaurants in Kentucky were found to be infected.
The most serious recent outbreak has struck in southeast Michigan, and included people who appeared to have been infected when they ate at certain restaurants, though that can’t be known with certainty. On May 27, the Detroit Free Press reported:
Christopher Larime goes out to lunch most days, often with co-workers from the General Motors Tech Center in Warren.
The father of three said he ate in March at the Buffalo Wild Wings across Mound Road from his office. It's the same restaurant where a food worker was later found to have hepatitis A.
Larime is one of 837 people sickened with the virus in Michigan since August 2016. It has killed 27 people in the state, which remains in the throes of the biggest hepatitis A outbreak in the country.
Vaccination that keeps restaurant workers from falling ill would also protect restaurant patrons, a fact that isn’t lost on health officials in the area, the Free Press reported:
The Wayne County Health Department and the City of Detroit's Health Department now recommend all restaurant employees and food handlers get the vaccine. Oakland County's Health Division also urges restaurant employees to consider vaccination.
Outbreaks in neighboring states were becoming so serious that the state of Indiana recommended that travelers to Michigan or Kentucky have themselves vaccinated against hepatitis A. But officials in those states noted that the chances of a tourist falling ill by eating at a restaurant were extremely small, despite the few restaurants where employees were found to be infected.
In April, Kentucky public health officials recommended the vaccine for all unvaccinated people in six counties there.
Bill Marler, publisher of Food Safety News, has written several opinion articles recently about the wisdom of hepatitis A vaccinations for restaurant workers. He urges routine vaccination for them.
And in the Kentucky-West Virginia area, all 215 employees involved in food preparation for a chain of food markets have volunteered to be vaccinated against hepatitis A; their employer, Forth Foods, provided the vaccinations. Way to protect employees, customers and public health!
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