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12/04/18: Kentucky food handler with hepatitis A exposes customers

jaundiced-eye-illustration

Hepatitis infection can cause a yellowing of the eyes and/or skin, which is referred to as jaundice.

The Ashland-Boyd County Health Department is investigating a case of Hepatitis A in a food preparation worker at a convenience store in Ashland, a Kentucky city on the southern bank of the Ohio River.

Hepatitis infection can cause a yellowing of the eyes and/or skin, which is referred to as jaundice. Photo illustration

Health officials say the employee prepared food at Ken’s Express Mart in the 900 block of 29th St. and worked from March 22 through April 7 while contagious. Generally, people who are infected with the liver virus can spread it before they begin having symptoms.

It can take as many as 50 days for symptoms to develop after exposure to hepatitis A, according to the Centers for Disease Control and Prevention.

There is a two-week window for people who are exposed to get the hepatitis A post-exposure vaccine. If the vaccine is given more than 14 days after exposure to the virus, it is not considered effective in preventing the disease.

The last day for customers exposed April 7 at Ken’s Express Mart to receive the post-exposure treatment is April 20. For people exposed between March 30 and April 6, there are fewer days left to obtain the post-exposure vaccine. It is past the two-week window of opportunity for customers who ate food or drank beverages from Ken’s convenience store between March 22 and March 29.

Often food handlers and food service workers are not confirmed as being infected until after they have developed symptoms and stopped working. The lag time from diagnosis to confirmation and finally reporting to public health officials frequently results in no opportunity for consumers to seek the post-exposure vaccine.

Erin Crace at the county health department said this case was identified quickly because local hospitals “do a wonderful job of getting us reports really quickly.” The area has seen an increase in cases, recording 23, since the outbreak was confirmed in November.

To prevent infection from future exposure, people should seek immunization. The hepatitis A vaccine was not available until recent years, so most adults have not received it.

Ken’s Express Mart is allowing employees to work there only if they have received the hepatitis A vaccine. In addition, Ken’s Express Mart has been notifying customers of the potential exposure, according to the health department. Local media quoted the owner as saying he began notifying customers of the possible exposure before the virus was confirmed in the employee.

Hepatitis A is usually transmitted person-to-person through the faecal-oral route, which includes consumption of contaminated foods or beverages, according to the CDC.

Most adults have symptoms including fatigue, low appetite, stomach pain, nausea and jaundice that usually resolve within two months of infection. Most children younger than 6 do not have symptoms or have unrecognized infections, but they can spread the virus.

Hepatitis A can live for months outside of the human body. It can survive freezing. It is very difficult to kill and most common cleaning fluids are not effective against it. Hand washing with soap and water is a strong defence. Waterless hand sanitizers are not effective at killing the virus.

Anyone who is experiencing symptoms should immediately contact their doctor or seek other medical attention.

Anyone with possible exposure and not experiencing symptoms is encouraged to contact their healthcare provider or the health department for a post-exposure hepatitis A vaccine.

Kentucky has been hit hard by a Hepatitis A outbreak, logging more than 100 cases and at least one death since November 2017.

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