From the Guidelines
Hepatitis A and E are the types of hepatitis that cannot become chronic, and individuals with acute hepatitis A should be restricted from working in food preparation. Hepatitis A is primarily transmitted through the fecal-oral route, making food handlers with this infection a significant public health concern, as noted in a study by the Advisory Committee on Immunization Practices (ACIP) 1. People diagnosed with acute hepatitis A should not handle food or work in food service until they are no longer infectious, which is usually about 1-2 weeks after the onset of jaundice or other symptoms. Unlike hepatitis B, C, and D, which can progress to chronic infections, hepatitis A and E are self-limiting diseases that resolve completely without becoming chronic. The restriction from food handling is necessary because during the acute phase, the virus is shed in stool and can contaminate food if proper hand hygiene is not maintained, as highlighted in the study 1. This precaution helps prevent outbreaks in community settings, such as the one reported in 1992, which resulted in significant medical and disease control costs 1. Once recovered, individuals develop immunity to hepatitis A and can safely return to food preparation work. Key points to consider include:
- Hepatitis A and E are self-limiting and do not progress to chronic infections
- Food handlers with acute hepatitis A can transmit the virus to others through contaminated food
- Restricting individuals with acute hepatitis A from working in food preparation is a necessary precaution to prevent outbreaks
- Proper hand hygiene is crucial in preventing the transmission of hepatitis A in food service settings, as emphasized by the study 1
From the Research
Types of Hepatitis and Chronic Infection
- Hepatitis A and E are typically associated with acute, self-limiting infections and are not known to lead to chronic infection in the general population 2, 3.
- Hepatitis B and C, on the other hand, can lead to chronic infection, which is associated with significant morbidity and mortality 2, 4.
- However, it has been reported that hepatitis E virus (HEV) genotype 3 can cause chronic infection in immunocompromised patients, such as those with solid organ transplants or HIV infection 3, 5.
Restrictions on Working in Food Preparation
- Individuals with hepatitis A are often restricted from working in food preparation due to the risk of transmission through contaminated food and water 2.
- Hepatitis E is also typically spread through the fecal-oral route, and individuals with HEV infection may be restricted from working in food preparation to prevent outbreaks 3, 5.
- There is no specific evidence to suggest that individuals with hepatitis B or C are restricted from working in food preparation, as these forms of hepatitis are primarily spread through blood and bodily fluids 2, 4.