How is Hepatitis A transmitted?


Hepatitis A is a communicable (or contagious) disease that spreads from person to person. It is transmitted by the "fecal -- oral route." This does not mean, or course, that Hepatitis A transmission requires that fecal material from an infectious individual must come in contact directly with the mouth of a susceptible individual. It is almost always true that the virus infects a susceptible individual when he or she ingests it, but it gets to the mouth by an indirect route.

Food contaminated with the virus is the most common vehicle transmitting Hepatitis A. The food preparer or cook is the individual most often contaminating the food. He or she is generally not ill: the peak time of infectivity (i.e., when the most virus is present in the stool of an infectious individual) is during the 2 weeks before illness begins. Hepatitis A is spread almost exclusively through fecal-oral contact, generally from person-to-person, or via contaminated food or water. Outbreaks associated with food have been increasingly implicated as a significant source of Hepatitis A infection. Such "outbreaks are usually associated with contamination of food during preparation by an HAV-infected food handler."2 Indeed, "[v]iral gastroenteritis was reported as the most common food-borne illness in Minnesota from 1984 to 1991, predominantly associated with poor personal hygiene of infected food handlers."3

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What is Hepatitis A?

2/28/2006

Hepatitis A is one of five human hepatitis viruses that primarily infect the human liver and cause human illness. (There are many other viruses that can inflame the liver which infect us more generally.) The other known human hepatitis viruses are hepatitis B, C, D, and E. Hepatitis A is relatively unusual in nations with developed sanitation systems such as the United States. Nevertheless, it continues to occur here.

Each year, an estimated 100 persons die as a result of acute liver failure in the United States due to Hepatitis A1. Approximately 30 - 50,000 cases occur yearly in the United States and the direct and indirect costs of these cases exceed $300 million1. The unfortunate aspect of these statistics is that with 21st century medicine, Hepatitis A is totally preventable, and isolated cases, and especially outbreaks relegated to food consumption, need not occur.

Viral Hepatitis is a major public health concern in the United States, and a source of si1gnificant morbidity and mortality.1 The Hepatitis A virus or "HAV" is heat stable and will survive for up to a month at ambient temperatures in the environment.

Hepatitis-A scare just a rumor

February 27, 2006
WEAR-TV (Florida)

Rumors of a Hepatitis-A outbreak at a local elementary school have parents on alert.

The principal at Berryhill Elementary sent out a letter on Friday telling parents about the rumors.

However, both the Santa Rosa Health Department and the school district say there has not been a confirmed case of Hepatitis-A and there is no indication that an outbreak exists.

Hepatitis is a highly contagious virus that attacks the liver and is usually transmitted by sharing food or not washing hands.

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Group pushes hepatitis plan

The advocates want to save costs by offering vaccinations to Hawaii's homeless
By Mary Vorsino
mvorsino@starbulletin.com

Hawaii's homeless are at high risk for contracting hepatitis A and B, whose treatment can cost more than $30,000 and last more than a year. But a $500, two-time vaccination for the infectious diseases is often not available to those on the streets.

Now, advocates and doctors -- fearing an outbreak and citing simple economics -- want to change that.

A bill moving through the state Legislature would require the state to hand out 500 hepatitis A and B vaccines to programs that help the homeless. The measure was pared down considerably from its first version, which would have given the state Department of Health an obligation to vaccinate all homeless for hepatitis A and B.

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Grower Wasn't Part of Hepatitis Inquiry

Officials dropped their probe of an October outbreak on a movie set without checking out the source of the lettuce seen as a likely cause.
By Rong-Gong Lin II, Times Staff Writer
February 10, 2006

Public health officials have suspected for weeks that a hepatitis A outbreak among 19 workers on a San Marino movie set might be linked to lettuce that came from a prominent Northern California grower.

But a contractor for the San Benito County company, Pride of San Juan, said this week that it had never been notified of the outbreak, let alone investigated as a possible source of tainted produce.

"This is news to us," said Karl Kolb, the contractor who handles food safety issues for the company. "No one has talked about this at all."

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Lawsuit Filed in LA-Area Hepatitis A Outbreak Case

FOR IMMEDIATE RELEASE
Marler Clark LLP, PS

LOS ANGELES, CA (February 7, 2006) -- The first of what may be multiple lawsuits resulting from recent Los Angeles-area hepatitis A outbreaks was filed Tuesday in Los Angeles County Superior Court. The lawsuit, filed on behalf of Michael Gallagher of Victorville, CA, names Silver Grill Location Catering as the defendant. According to the lawsuit, Mr. Gallagher contracted hepatitis A after consuming contaminated food manufactured and sold by Silver Grill. Mr. Gallagher is represented by Marler Clark, a Seattle law firm that has successfully represented thousands of victims of foodborne illness, and Ralph Martinez, a respected Los Angeles attorney.

The lawsuit alleges that Silver Grill Location Catering served the tainted meal that sickened Mr. Gallagher on October 3, 2005, during production of "The Good German," a film starring George Clooney and Cate Blanchett. At least eighteen other people on the movie set also became ill with hepatitis A infections after eating the contaminated food. Local health authorities believe the contaminated food to have been lettuce. The lawsuit seeks damages to account for Mr. Gallagher's medical and medical-related expenses, emotional distress, and loss of enjoyment of life. The suit also seeks compensation for the lost wages that Mr. Gallagher incurred during his illness.

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News update

Feb. 7, 2006

Ten people who ate or worked at the Bamboo Grill in northwest Phoenix in December have contracted hepatitis A, a viral illness that is spread by consuming contaminated food or water.

Despite health officials' initial belief that none of the three restaurant workers who became ill had contact with food at the restaurant at 3049 W. Agua Fria Freeway, seven diners were infected with the virus. All are recovering.

The source of the exposure remains unclear.

11PM Investigative Report: 'Outbreak!'

February 2, 2006

Investigator Joel Grover, who spent years exposing problems at dirty restaurants, is hot on the trail of the Southland's latest food safety mystery!

"We uncovered a group of victims -- people infected with the Hepatitis A disease but didn't know it," Grover says. "We confronted the health department. Why don't they let the public know about outbreaks?"

Could you have been exposed?

Watch "Outbreak," Thursday at 11 p.m., only the Channel 4 News! Look for the report on the Web at 9 a.m. Friday!

2 Sources of Hepatitis A Named

February 2, 2006
Rong-Gong Lin II, Times Staff Writer
LA Times

County health officials report outbreaks of the virus last fall at an Olvera Street restaurant and a catering firm favored by film studios.

Los Angeles County public health officials confirmed Wednesday that hepatitis A outbreaks last fall hit a popular Mexican restaurant in downtown Los Angeles and a North Hollywood catering company favored by big movie studios.

At La Golondrina on Olvera Street, 15 patrons fell ill after eating there Sept. 14 or 15, said Elizabeth Bancroft, a county medical epidemiologist.

On Oct. 3, Silver Grill Catering served what the county suspects was contaminated baby green lettuce, leaving 19 ill.

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Wash Your Hands: Hepatitis-A Outbreak Downtown

Feb. 1, 2006

Los Angeles may be suffering an outbreak of Hepatitis A - a fourfold increase in two years, reports CBS2/KCAL9's David Goldstein.

Hot spots include downtown restaurants like Cafe Pinot on Fifth Street and La Golondrina on Olvera Street, says the CBS report, in a rare display of capital-J-journalism that seems to have beaten the mainstream newspapers.

Me, I'm staying away from the salad bars and getting more fanatical about washing my hands. I like my liver just as it is ...

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County reports handful of hepatitis A cases

By Tim Hrenchir
The Capital-Journal
February 1, 2006

State and local health officials are searching for the source of an outbreak that has resulted in four confirmed cases of hepatitis A this week in Shawnee County.

Katie Schurman, community relations specialist for the Shawnee County Health Agency, said the agency's communicable disease team and the Kansas Department of Health and Environment on Tuesday were interviewing those who were infected and people who are close to them to try to find common activities or connections.

Schurman said hepatitis A is an infection that is transmitted through the oral-fecal route, which means that to be infected a person must have oral contact with something that -- though it might look clean -- is contaminated with the stool, or feces, of an infected person.

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Unwashed produce can make you sick

Food-borne illnesses, outbreaks are on the rise
By JANE ZHANG
The Wall Street Journal
01/31/2006

More Americans are eating their vegetables. But the healthy trend comes with a risk: Illnesses traced to fresh produce are on the rise.

Fruit and vegetables are now responsible for more large-scale outbreaks of food-borne illnesses than meat, poultry or eggs. Overall, produce accounts for 12 percent of food-borne illnesses and 6 percent of the outbreaks, up from 1 percent of the illnesses and 0.7 percent of outbreaks in the 1970s, according to the Centers for Disease Control and Prevention.

Several factors are responsible: the centralization of produce distribution, a rise in produce imports, as well as the growing popularity of prechopped fruit and vegetables. Both the government and the industry have identified five products that are particularly problematic: tomatoes, melons (especially cantaloupes), lettuce, sprouts and green onions.

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County links Hepatitis A case to restaurant

Angela Gonzales

The Business Journal

The Maricopa County Department of Public Health is linking a case of Hepatitis A to a Phoenix restaurant.

An employee of the Bamboo Grill restaurant at 3049 W. Agua Fria Freeway in Phoenix has been diagnosed with Hepatitis A. Now the county health department is investigating two other suspected cases among employees.

None of them are cooks and none have had direct contact with food, according to the county health department. It is unclear whether they were exposed to the disease by eating food together at the restaurant or elsewhere.

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