Hepatitis A: A Virus that Causes Foodborne Illness

HYG-5579
Family and Consumer Sciences
Date: 
01/23/2013
Written by Lydia Medeiros and Jeffery LeJeune

Hepatitis is an inflammation of the liver, a condition caused by a family of viruses that includes Hepatitis A, B, and C. Hepatitis A is a pathogen found in human feces. Contamination of water and food by food handlers who are infected with Hepatitis A and who practice poor personal hygiene is the main cause of the foodborne illness.

Symptoms of illness

Hepatitis A presents with sudden onset of fever, fatigue, anorexia, and abdominal pain. An infected person may have jaundice for several days because of liver inflammation. Symptoms appear 10 to 50 days after exposure to the virus, depending on the dose of virus particles ingested. The illness lasts for up to two weeks.

Public health consequences

The exact number of Hepatitis A cases that occur each year is hard to determine because many people attribute their illness to the flu. The local Health Department and Centers for Disease Control and Prevention (CDC) cannot record the number of cases accurately unless the ill person seeks medical care, which is unusual in mild cases. The CDC has calculated an estimate of the number of cases of Hepatitis A based on corrections for under reporting, misdiagnosis, and the number of cases that are not caused by contaminated food.

The CDC estimates that there are over 1,500 cases of Hepatitis A each year in the United States, and that 7% of the cases are caused by eating contaminated food. The remaining cases are caused by environmental contamination. About 31 cases will be severe enough to require hospitalization; 7 deaths are possible each year.

Risk factors

Anyone can get Hepatitis A, but persons who have low immunity due to a chronic disease are especially susceptible. The reason is that Hepatitis A is found in human feces and anyone who comes in contact with the virus in the environment or contaminated food can become ill. If an infected person touches food or water, then the virus can be passed along to another person.

Foods implicated

Any food can be contaminated with Hepatitis A. The foods most often implicated in foodborne illnesses are foods served cold or raw, such as salads. The good news about this virus is that it doesn't multiply in foods or water like bacteria. If you are traveling in an area that appears to have polluted water, drink bottled beverages without ice. Avoid uncooked foods.

How can you control this pathogen in your home?

1. Wash hands with warm soapy water before and after handling raw foods.

  1. First, wet your hands.
  2. Add soap to your hands.
  3. Rub both sides for at least 20 seconds.
  4. Rinse thoroughly.
  5. Air dry, or dry your hands with a clean towel or paper towel.
  6. Wash hands with warm soapy water before and after handling raw foods.
  7. Always wash your hands after using the toilet or after changing a baby's diaper.
  8. Prepare food for yourself but not others if ill with diarrhea.

2. Wash fruits and vegetables before eating them.

  1. Do not eat raw alfalfa and other raw sprouts.
  2. Use water from a safe water supply for drinking and washing fresh produce.
  3. Remove outer wilted and damaged areas before washing.
  4. Only wash and prepare the amount you will use in one meal.
  5. Refrigerate remaining vegetables without washing, or dry with a paper towel or in a salad spinner.

3. Knives, cutting boards, and food preparation surfaces should be washed with hot water and soap after contact with raw foods.

  1. Clean sinks and counters with paper towels or clean cloths and hot soapy water before and after cooking food.
  2. Wash knives, cutting boards, and counters with hot water and soap after you work with raw food.
  3. Scrub your cutting board with dish soap. If your cutting board is not made of wood, you can put it into the dishwasher.
  4. Sanitize all food preparation surfaces after contact with raw foods. Use a commercial sanitizer for kitchens or make a sanitizer with 1 teaspoon of 6% chlorine bleach in 1 quart clean water.

4. Use a thermometer to make sure that raw foods are cooked to safe temperatures; at least 185 degrees F to destroy Hepatitis A.

  1. The only way to be sure food is to 185 degrees F is to check with a food thermometer.
  2. Foods cooked to 185 degrees F are usually considered overcooked and of low quality. It is best to avoid contamination of raw foods with Hepatitis A so it will not be necessary to decontaminate foods by cooking to high temperatures.

References

Centers for Disease Control and Prevention. Hepatitis A. cdc.gov/hepatitis/A/PDFs/HepAGeneralFactSheet_BW.pdf. Accessed: August 16, 2011.

Fiore, A.E. Hepatitis A Transmitted by Food. Clinical Infectious Diseases 2004;38:705–715.

Hillers, V.N., Medeiros, L.C., Kendall, P., Chen, G., & DiMascola, S. Consumer food handling behaviors associated with prevention of 13 foodborne illnesses. Journal of Food Protection 2003;66:1893–1899.

Scallan, E., Hoekstra, R.M., Angulo, F.J., Tauxe, R.V., Widdowson, M.A., Roy, S.L., Jones, J.L., & Griffin, P.M. Foodborne illness acquired in the United States—Major pathogens. Emerging Infectious Diseases 2011;17:7–15.

U.S. Food and Drug Administration. Hepatitis A Virus. The Bad Bug Book. fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm071294.htm. Accessed: August 16, 2011.

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