Hepatitis A and Food Handling

Hepatitis A is a highly contagious virus spread by the faecal-oral route, and food handlers are a well-known source of outbreaks. It passes from an infected person's stool to food when hands are not washed properly after using the toilet. The best defences are thorough handwashing, excluding ill or recently ill staff, and careful handling of high-risk ready-to-eat foods. This guide explains how the virus spreads and how to control it. Key takeaways: Hepatitis A spreads by the faecal-oral route: microscopic traces of stool reach food, usually via unwashed hands.. Infected people can shed the virus and be contagious for one to two weeks before symptoms appear, so healthy-looking staff can still spread it.. Thorough handwashing with soap and warm running water after every toilet visit is the single most important control.. Food handlers who are ill with vomiting, diarrhoea, jaundice or a confirmed infection must be excluded from handling food.. Ready-to-eat foods that receive no further cooking, and foods handled a lot by hand, carry the highest risk.. What hepatitis A is and why it matters in food Hepatitis A is a viral infection of the liver caused by the hepatitis A virus. In food businesses it matters because it is one of the classic causes of food-handler-linked outbreaks worldwide. The virus is passed out in the stool of an infected person and can survive for a considerable time on hands, surfaces and in food. Only a very small amount is needed to infect someone. Unlike bacteria, viruses do not grow in food, but they do not need to: they simply need to be transferred to a food that people will eat. Because the illness can be serious, and because a single infected handler can expose many customers, hepatitis A is treated as a priority hazard in ready-to-eat food service. It is a virus, not a bacterium, so it will not multiply in food but is easily carried on it.. A very low dose can cause infection.. It targets the liver and can cause weeks of illness.. One infected handler can expose a large number of customers.. How it spreads: the faecal-oral route Hepatitis A spreads by the faecal-oral route. In practical terms, microscopic traces of an infected person's stool are transferred to their hands, and from there to food, utensils, or surfaces that other people then put in their mouths. In a food business the most common pathway is an infected handler who does not wash their hands properly after using the toilet, then touches ready-to-eat food. It can also spread through contaminated water, or through raw or lightly cooked shellfish harvested from sewage-affected water. Person-to-person spread within a household or workplace is common too. Understanding the route makes the controls obvious: break the chain between the toilet and the food, and you stop the virus. Toilet to hands to food is the main workplace pathway.. Contaminated water and ice can carry the virus.. Raw or lightly cooked shellfish from polluted water is a known source.. Close person-to-person contact also spreads it outside work.. The problem of the incubation period Hepatitis A has a long incubation period, typically several weeks between exposure and the first symptoms. This is what makes it so dangerous in food handling. An infected person can begin shedding the virus in their stool, and be highly contagious, for roughly one to two weeks before they feel unwell. During that window they look and feel healthy, come to work as normal, and can unknowingly contaminate food. This is exactly why food safety cannot rely only on sending home staff who look sick. It must be built on consistent hygiene by everyone, all the time, because you can never be certain who is incubating an infection. Symptoms can take weeks to appear after infection.. Handlers are contagious before they feel ill.. Healthy-looking staff can still shed the virus.. Routine hygiene by all staff is the only reliable safeguard.. Recognising the symptoms Symptoms of hepatitis A, when they do appear, often include fever, tiredness, loss of appetite, nausea, abdominal discomfort and dark urine. A hallmark sign is jaundice, a yellowing of the skin and the whites of the eyes. Symptoms can be mild or last for several weeks, and young children may show few or no symptoms while still being infectious. Any food handler who develops jaundice, or who has vomiting or diarrhoea, should not be handling food and should seek medical advice. A doctor can confirm hepatitis A through a blood test, and infections are notifiable to public health authorities, who may follow up with the business. Fever, fatigue, nausea and appetite loss are common early signs.. Jaundice (yellow skin or eyes) and dark urine are strong indicators.. Children can be infectious with few visible symptoms.. Hepatitis A is medically confirmed by a blood test and is notifiable.. Handwashing: your primary control Because the virus travels from stool to food on hands, thorough handwashing is the single most effective control a food business has. Hands must be washed with soap and warm running water, working up a lather, scrubbing all surfaces including between fingers and under nails, then rinsing and drying with a single-use towel. This must happen every time after using the toilet, before handling food, after handling raw foods or waste, and after any break. Alcohol-based hand sanitiser is not a reliable substitute against hepatitis A and should never replace proper washing. Provide dedicated handwash basins that are always stocked with soap and paper towel, and never use them for food prep or dishwashing. Use soap and warm running water; lather, scrub, rinse and dry.. Wash after every toilet visit, before food handling, and after breaks.. Do not rely on sanitiser gel alone; it is not reliable against this virus.. Keep handwash basins separate, accessible and always stocked.. Excluding ill and recently ill handlers Under the Food Standards Code, food handlers have a duty to report to their supervisor if they may be suffering from or carrying a foodborne illness, and businesses must ensure people known to be ill do not contaminate food. In practice, any handler with vomiting, diarrhoea, jaundice or a diagnosed hepatitis A infection must be kept away from handling food and food-contact surfaces. Because a person can remain infectious after symptoms ease, do not rush staff back. Follow your doctor's and public health unit's advice on when it is safe to return; the exact exclusion period is determined by health authorities, so confirm with your state or territory regulator and local public health unit rather than guessing. Handlers must report illness or possible carriage to their supervisor.. Exclude anyone with vomiting, diarrhoea, jaundice or confirmed hepatitis A.. Do not return staff to food duties on the basis of feeling better alone.. Confirm the safe return date with a doctor and public health authorities.. High-risk foods and other safeguards The highest-risk foods are ready-to-eat items that receive no further cooking and are handled a lot by hand: salads, sandwiches, garnishes, sliced fruit, cold platters and desserts. Because these are eaten as served, any virus on a handler's hands goes straight to the customer. Cooking foods thoroughly to a safe core temperature will inactivate the virus, but many high-risk items are never reheated. Beyond handwashing and exclusion, other safeguards include using clean utensils, tongs or gloves rather than bare hands for ready-to-eat food, sourcing shellfish from approved suppliers, using safe water and ice, and keeping surfaces clean and sanitised. Vaccination against hepatitis A is available and worth discussing with a doctor, especially for higher-risk settings. Ready-to-eat, hand-handled foods carry the greatest risk.. Use tongs, utensils or single-use gloves instead of bare hands.. Source shellfish from approved suppliers and use safe water and ice.. Thorough cooking inactivates the virus, but many risk foods are uncooked.. Ask a doctor about hepatitis A vaccination for at-risk staff.. Checklist: Handwash basins are stocked with soap and single-use towels at all times.. Staff wash hands after every toilet visit, before food prep and after breaks.. A clear policy requires staff to report illness, including diarrhoea, vomiting or jaundice.. Ill or recently ill handlers are excluded until cleared to return.. Ready-to-eat foods are handled with tongs, utensils or gloves, not bare hands.. Shellfish comes from approved suppliers and water and ice are from a safe source.. Surfaces and equipment are cleaned and sanitised regularly.. Staff are trained on the faecal-oral route and know it can spread before symptoms show.. Common mistakes: Relying on hand sanitiser gel instead of washing with soap and water.. Assuming a handler who looks well cannot be contagious.. Letting staff return to food duties as soon as they feel a bit better.. Using bare hands for salads, sandwiches and other ready-to-eat foods.. Using the handwash basin for food prep or rinsing equipment.. Not having a clear, enforced policy for staff to report illness..