Hepatitis A (HAV) is a virus that can infect people and cause severe illness. This virus can withstand environmental conditions common in food and water. Although HAV does not act like bacteria by multiplying in food and water, the virus can be carried from one person to another by these items. There can also be direct person-to-person transmission.
Mild symptoms of HAV often begin occurring between two to four weeks after the contaminated food or water has been consumed. Symptoms can take as long as ninety days to occur and some cases have lasted up to six months. This virus causes an inflammation of the liver. Symptoms may include fever, low appetite, nausea, vomiting, diarrhea, muscle aches and yellowing of the whites of the eyes and skin (jaundice). In some cases, the illness has caused severe liver damage and death.
Water, raw shellfish and ready-to-eat foods like salads contaminated with HAV have been the most commonly reported sources of transmission. The virus is spread when infected people do not properly wash their hands after using the restroom and then touch foods or food contact surfaces. Indirect sources of transmission are the surfaces that come into contact with foods such as utensils and work surfaces in the kitchen. This is particularly true when the food being handled is going to be consumed without cooking like raw shellfish.
Childcare facilities are among the facilities that have the potential to have problems with HAV transmission. Children with this virus under the age of six often do not show symptoms. Diaper changing can contaminate hands of staff as well as children. When hands are not properly washed they can contaminate surfaces where foods are prepared and objects that children can put into their mouths.
Some travelers are at higher risk of exposure in countries with poor sanitation. Health care workers are also at higher risk of exposure and transmission of this virus since they come into direct contact with patients ill from this virus.
Tips for preventing the spread of this illness can be found on our tips page. To reduce the potential spread of HAV additional control measures may be required for persons associated with high-risk activities or settings such as food handlers, childcare facility personnel and health care workers. Specific guidance and recommendations can be found in a manual titled Prevention and Control of Communicable Diseases. Additional guidance for retail food establishment management can be found in Chapter 2 of the food code.
For additional information on HAV, please visit the following references: Centers for Disease and Control and Prevention website and FDA’s Bad Bug Book. For data on reported HAV cases in Missouri, visit the communicable disease data and statistical reports page for the annual reports listed there.