Hepatitis A and Food Service Workers (infectious hepatitis) (2023)

Last Reviewed: February 2007

What is hepatitis A?

Hepatitis A is a highly contagious disease that attacks the liver. It is the most common type of hepatitis reported in the United States.

Who gets hepatitis A?

Anyone can get hepatitis A, but certain persons are at increased risk of infection, including:

  • Children and adults living in areas with increased rates of hepatitis (i.e., certain Western states in the U.S.)
  • Persons traveling to countries where hepatitis A is common (i.e., Central and South America, Africa, the Middle East, Asia and the Western Pacific)
  • Men who have sex with men
  • Injecting and non-injecting drug users
  • Sexual contacts of infected persons
  • Household contacts of infected persons

How is the virus spread?

Hepatitis A virus is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. This type of transmission is called the "fecal-oral" route. For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed.

(Video) Oakland County holds Hepatitis A clinics for food service workers

Most infections in the United States result from contact with a household member or sex partner who has hepatitis A.Hepatitis A virus may also be spread by consuming food or drink that has been handled by an infected person. Waterborne outbreaks are infrequent and are usually associated with sewage-contaminated or inadequately treated water. Casual contact, as in the office, factory or school setting, does not spread the virus.

What are the symptoms of hepatitis A?

The symptoms of hepatitis A may include an abrupt onset of fever, malaise, loss of appetite, nausea, stomach pain, dark-colored urine and jaundice (a yellowing of the skin and whites of the eyes). The disease is rarely fatal and most people recover in a few weeks without any complications. Adults have signs and symptoms of illness more often than children. Infants and young children tend to have very mild symptoms and are less likely to develop jaundice than are older children and adults. Not everyone who is infected will have all of the symptoms.

How soon do symptoms appear?

The symptoms commonly appear within 28 days of exposure, with a range of 15-50 days.

For how long is an infected person able to spread the virus?

The contagious period begins one to two weeks before symptoms appear, and is minimal about one week after the onset of jaundice. Food workers should be excluded from work for at least two weeks after the onset of clinical symptoms of hepatitis A. If jaundiced, food workers should not return to work for at least one week after onset of jaundice.

(Video) Hepatitis A infection in food service employee on Hawaii Island

Does past infection with hepatitis A make a person immune?

Once an individual recovers from hepatitis A, he or she cannot be re-infected. He or she is immune for life and does not continue to carry the virus.

What is the treatment for hepatitis A?

There are no special medicines or antibiotics that can be used to treat a person once the symptoms appear.

How can hepatitis A be prevented?

To prevent person-to-person spread, careful hand washing after using the bathroom, changing diapers and before preparing or eating food, is the single most important means of prevention.

Foodborne hepatitis A outbreaks are relatively uncommon in the United States; however, when they occur, intensive public health efforts are required for their control. To prevent the spread of hepatitis A from an infected food worker to co-workers and/or restaurant patrons, food workers should never touch ready-to-eat foods with bare hands, and should carefully wash their hands after using the bathroom, even if the food worker does not feel sick. Food workers should never work while they are sick with stomach (gastrointestinal) illnesses.

(Video) Florida’s top doctor: Majority of hepatitis A-infected restaurant workers kept secret from public

Immune globulin shots are effective in preventing the spread of hepatitis A if given within 14 days of exposure. Immune globulin may be recommended for co-workers of infected food workers. Under certain circumstances, particularly when recommended food safety procedures are not followed by food workers, public health officials may recommend that restaurant patrons receive immune globulin.

For long-term protection, hepatitis A vaccine is the best method of prevention.

Who should obtain the hepatitis A vaccine?

Hepatitis A vaccine is recommended for the following persons:

  • Travelers to areas with increased rates of hepatitis A
  • Men who have sex with men
  • Injecting and non-injecting drug users
  • Persons with clotting-factor disorders (e.g., hemophilia)
  • Persons with chronic liver disease (including persons with chronic hepatitis B or chronic hepatitis C virus infection)
  • All children aged 12-23 months; children not fully vaccinated by age two

The hepatitis A vaccine may also be used in certain outbreak situations where ongoing transmission is occurring. Although studies of certain occupational groups (for example, food service workers, health care workers, child care workers, sewerage workers) have not shown an increased risk, such people may consider vaccination if they wish to further reduce their risk or are in communities where ongoing outbreaks are occurring.

(Video) Palm Beach County Food Service Worker Tests Positive For Hepatitis A

Why isn't hepatitis A vaccine required for food service workers?

While food service employers can offer hepatitis A vaccine to their employees if they wish, most public health authorities prefer not to make it mandatory for the following reasons:

  • There is no evidence that food service workers are at any greater risk of acquiring hepatitis A than are people in other occupations.
  • Only 2-3 percent of all hepatitis A cases are acquired through restaurant food.
  • Employee turnover in some segments of the food service industry is high, making it impractical to vaccinate staff.
  • Emphasis on careful hand washing, use of disposable gloves and not working when ill are measures that can greatly minimize the risk of spreading hepatitis A and a number of other infections.
  • Hepatitis A vaccine would be strongly recommended for food service workers in a county or region where a community-wide outbreak has been recognized.

What about the vaccine?

Currently, there are two hepatitis A vaccines on the market. Both vaccines are safe and highly effective. Two doses given at least six months apart, are recommended. Approximately 99-100 percent of persons vaccinated with hepatitis A vaccine will develop long-lasting immunity.

Where can I obtain more information?

People interested in receiving the vaccine should contact their health care provider or employer. For general information, please call your local health department.


Can someone with hepatitis A work in food service? ›

Any employee infected with Hepatitis A, whether or not they are exhibiting symptoms, is a risk to food safety and is putting public health in danger. An infected food worker is the most common way Hepatitis A is transmitted in foodborne illness outbreaks.

What should a manager do if a food worker is diagnosed with hepatitis A? ›

The manager of the food establishment must report to the local health department when a food handler has jaundice or a hepatitis A diagnosis. Food handlers must not handle unwrapped foods for at least 30 days if they had close personal contact or are living with someone diagnosed with hepatitis A.

What type of illness is hepatitis A food handlers? ›

Hepatitis A is caused by hepatitis A virus (HAV). Transmission occurs by the fecal-oral route, either by direct contact with an HAV-infected person or by ingestion of HAV-contaminated food or water. Foodborne or waterborne hepatitis A outbreaks are relatively uncommon in the United States.

When food service workers do not follow good hygiene practices which strain of hepatitis virus can be transmitted? ›

Hepatitis A virus (HAV) is an important pathogen which has been responsible for many food-borne outbreaks. HAV-excreting food handlers, especially those with poor hygienic practices, can contaminate the foods which they handle.

Can you work if you have hepatitis A? ›

In general, people infected with hepatitis A may return to work or school when they no longer have symptoms, but they must be sure to carefully wash their hands after using the bathroom.

Can I be around people if I have hepatitis A? ›

Hepatitis A can be spread from close, personal contact with an infected person, such as through having sex, caring for someone who is ill, or using drugs with others. Hepatitis A is very contagious, and people can even spread the virus before they feel sick.

What precaution should be used to a patient with hepatitis A? ›

The transmission of hepatitis A is mainly faeco-oral, and the infection control measures those called "Enteric Precautions", or blood and body fluid precautions. These include the wearing of latex gloves when handling faeces, urine, saliva, and blood. Handwashing is essential.

Do I have to tell my employer I have hepatitis A? ›

What you need to know. Answer: People are not required by law to disclose their health information to their employers, unions, or co-workers, including if they have hepatitis C or in treatment for hepatitis C.

How long are you contagious hepatitis A? ›

Hepatitis A is highly contagious. Most infected individuals are very contagious shortly after developing symptoms, but hepatitis A can be spread from two weeks before symptoms appear to a few weeks after infection. Hepatitis A can survive outside the body for months, depending on environmental conditions.

Can hepatitis A spread by sharing food? ›

The hepatitis A virus is usually spread by putting something in your mouth that is contaminated with the virus. The virus is found in the stool of people with hepatitis A and is spread when someone's stool accidentally contaminates food or water.

How do you get hepatitis A from food? ›

You eat or drink food or water that has been contaminated by stools (feces) containing the hepatitis A virus. Unpeeled and uncooked fruits and vegetables, shellfish, ice, and water are common sources of the disease. You come in contact with the stool or blood of a person who currently has the disease.

How is hepatitis A transmitted to food? ›

The hepatitis A virus is transmitted primarily by the faecal-oral route; that is when an uninfected person ingests food or water that has been contaminated with the faeces of an infected person. In families, this may happen though dirty hands when an infected person prepares food for family members.

How would you prevent the contamination of food by hepatitis A virus? ›

Preventing Foodborne Illness at Home
  1. Wash hands with warm water and soap for at least 20 seconds before and after handling raw foods.
  2. Thoroughly wash hands after using the bathroom and changing diapers for protection against hepatitis A, as well as other foodborne diseases.
Dec 22, 2021

How is hepatitis A transmitted and what is the best way to prevent it? ›

People are infected by passing the virus from contaminated hands to their mouths or by eating foods that contain the virus.
The five most important steps to keep the disease from spreading are:
  • Good hand washing.
  • Plenty of rest.
  • Good nutrition.
  • Good housekeeping.
  • Medical care.

What is the most common transmission of hepatitis A in a restaurant? ›

Michael Basista, MD, a gastroenterologist with ProMedica Physicians, said that patrons have a fairly low risk of acquiring hepatitis A from a restaurant employee. Like other viruses, it's spread when food, typically uncooked food (such as a salad) or already cooked food, is touched by the person infected.

Do I have to quarantine with hepatitis A? ›

Hepatitis A is very contagious. This means that you can easily catch the virus from someone or give it to someone else. You are most contagious soon after you are infected and before symptoms appear. Adults who are otherwise healthy are no longer contagious 2 weeks after the illness begins.

Should you work with hepatitis? ›

According to the Centers for Disease Control and Prevention (CDC) , there's no reason to exclude people with hepatitis C from any type of job. This includes individuals who work with children, food, and other services. The only exception is if the job poses a risk of blood-to-blood contact.

Should I be worried about hepatitis A? ›

Hepatitis A can be quite serious. While most people fully recover within 2–3 months, older people, those with chronic liver disease or other health problems may develop severe illness.

Can you share a bathroom with someone with hepatitis A? ›

Hepatitis A can easily spread from one person to another by putting something in the mouth (even though it may look clean) that has been contaminated with the stool of a person with hepatitis A. This can happen when people do not wash their hands after using the toilet and then touch or prepare other people's food.

How can you prevent hepatitis A from spreading? ›

Practicing good hand hygiene — including thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food — plays an important role in preventing the spread of hepatitis A.

Is hepatitis A contagious by saliva? ›

Hepatitis A virus (HAV) is shed in feces but also in saliva. HAV RNA was detected in saliva in five out of six acutely infected patients with HAV viremia. Serum and saliva sequences were identical. The simplicity of obtaining material allows the recommendation of the use of saliva for investigation of outbreaks.

Does hepatitis A need to be reported? ›

All states require health care facilities and providers to report hepatitis A diagnoses.

Is hepatitis A service connected disability? ›

Yes. Hepatitis C does qualify for VA disability benefits and, more importantly, can be granted a disability rating as high as 100% if the symptoms are near-constant and debilitating. Symptoms included in the rating schedule include nausea, vomiting, fatigue, malaise, anorexia, joint pain, and liver pain.

How contagious is hepatitis A? ›

Hepatitis A is very contagious. It is spread when someone unknowingly ingests the virus — even in microscopic amounts — through close personal contact with an infected person or through eating contaminated food or drink.

What can you not do with hepatitis A? ›

Avoid alcohol and use medications with care.

If you have hepatitis, don't drink alcohol. It can cause liver damage. Talk to your health care provider about all the medications you take, including medications available without a prescription.

What should you not do if you have hepatitis A? ›

People with acute hepatitis should avoid alcohol and drugs that are toxic to the liver, including acetaminophen (Tylenol) during the acute illness and for several months after recovery. Fatty foods may cause vomiting and are best avoided during the acute phase of the illness.

Can you get hepatitis A from a restaurant? ›

Currently there are outbreaks of hepatitis A across the US. The virus is spread through stool (feces/poop) of people with the virus. People can get hepatitis A by eating food or water contaminated with feces of a person that has the virus, or through person-to-person contact with someone that has the virus.


1. Hepatitis A . What food professionals need to know.
(KCHD News Network)
2. Sarasota food service worker tests positive for hepatitis A, health officials say
(ABC Action News)
3. Seafood restaurant worker diagnosed with hepatitis A
(10 Tampa Bay)
4. Georgia restaurant employee worked while infected with hepatitis A
5. Hepatitis A: An Update in the Context of an Outgoing Multi-state Outbreak with Dr. Anupama Raghuram
(UofL Internal Medicine Lecture Series)
6. Hepatitis A in children Frequent asked Questions
(اد محمد عز رابطه اطباء الأطفال فى الدقهليه)
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