In response to a recent outbreak of hepatitis A in Michigan, the Michigan Department of Agriculture and Rural Development (MDARD) and the Michigan Department of Health and Human Services are providing the following guidance to operators of licensed food facilities in Michigan.
The outbreak continues to spread, and your help is needed to prevent additional illnesses and possible outbreaks in your food establishment.
With your assistance, we can stop the spread of hepatitis A and help keep your employees and customers healthy.
What is hepatitis A?
Hepatitis A (HAV) is a highly contagious disease that attacks the liver. People infected with HAV are most contagious from two weeks before onset of symptoms to one week afterwards. Not everyone who is infected will have all the symptoms listed below. Symptoms usually start within 28 days of exposure to the virus with a range of 15-50 days. These symptoms can include:
- Jaundice (yellowing skin and whites of eyes)
- Loss of appetite
- Nausea and vomiting
- Stomach pain
- Dark-colored urine
- Pale or clay colored stool
How is HAV spread?
- HAV is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with HAV, usually due to poor hygiene.
- Most infections in the U.S. are from contact with a household member or through close personal contact with a person who has HAV (e.g., sharing towels, cigarettes, toothbrushes or eating utensils; having sex with someone who is infected; or through IV drug use).
- HAV may also be spread by consuming food or drink that has been handled by an infected person.
How is HAV treated or HAV infection prevented?
- HAV vaccine can prevent infection and is strongly recommended for food workers in the outbreak area.
- No medicines can cure the disease once symptoms appear. People with HAV symptoms should seek medical care.
- Most people get better over time, but may need to be hospitalized.
- Previous infection by HAV gives immunity from future infection.
- People may be treated with vaccine or immune globulin within 14 days of exposure if they have not yet shown symptoms.
How can you reduce the chance of HAV transmission in your food facility?
- Ensure employees know to report any illness symptoms to you, including onset of jaundice or others listed above.
- Inform employees that they need to tell you right away if they have a household member or other close contact that has been diagnosed with HAV.
- If your food establishment is within the current outbreak area, encourage employees to get HAV vaccine. Vaccine is available through most healthcare providers and pharmacies. Those without health insurance coverage should contact the local health department to check on availability of free or low-cost vaccination.
What should you do if you find out about an infected food worker or have a worker with the symptoms listed above?
- Immediately notify your local health department and ask what to do next.
- Send the worker home immediately and ask the regulatory authority for guidance on when the employee can return to work.
What should you expect if you have an HAV positive employee?
- Operators will be asked to provide information on the employee’s work schedule, duties, co-workers and possibly other records.
- Operators may need to work with the local health department or regulatory authority on employee vaccinations.
- If there is a concern for HAV transmission to consumers, especially if food safety procedures are not followed by food workers, a press release recommending consumers get immune globulin or HAV vaccine may be needed.
For more information on hepatitis A, including information about the current outbreak area, visit www.michigan.gov/hepatitisAoutbreak