Washing Hands

Hepatitis A: What We Know (and Can Learn) from the Outbreaks

Chip Manuel, Ph.D.


By Chip Manuel, Ph.D.

Food Safety Science Advisor

According to the Florida Department of Health (FDOH), the state had 106 hepatitis A cases in 2014.

123 in 2015.

122 in 2016.

In 2017, that number doubled to 276.

In 2018, it almost doubled again – reaching 548 cases.

As of August 3, that number is almost 4x the number of cases from the previous year. In 2019, 2,192 hepatitis A cases have been reported to date. In fact, in the week of July 28 to August 3, 81 hepatitis A cases were reported.1


While Florida is getting the most media attention, 29 states have reported an ongoing hepatitis A outbreak, according to the CDC.

Since the outbreaks have been identified in 2016, there have been over 23,000 cases, 14,300 hospitalizations (60%) and 236 deaths.

While the CDC is monitoring the outbreaks and evaluating the root cause, citizens should have an awareness of what the virus is, and what the symptoms are.

Hepatitis A is a contagious virus that infects the liver and is usually spread through the feces of people who have contracted the virus. A person infected with hepatitis A virus is contagious two weeks before showing symptoms, and not everyone infected by the virus will have symptoms. If personal hygiene and surface sanitization measures aren’t followed, the virus can spread from objects, food and drinks.

In a high-risk environment like a restaurant, good hygiene is critical. Recent news headlines have sometimes included public health alerts about a contagious restaurant worker unknowingly exposing customers to hepatitis A. FDOH reported that “less than 5% of cases have been identified among food workers” and they have not “identified a case of hepatitis A transmission from a food worker to a restaurant patron.” 2

According to the CDC, the hepatitis A virus is spreading from person to person primarily among people using drugs or living in poor sanitary conditions. For general information, the CDC’s hepatitis A outbreak fact sheet is a great resource.3

Because various regions of the United States have witnessed a steep rise in the number of hepatitis A cases, the focus on the virus is getting more attention due to the fact it has “escalated to a worrying degree.”

That’s why it is critical to look for the symptoms.

Symptoms include:

  • Yellow Skin or Eyes
  • Feeling Tired
  • Loss of Appetite
  • Upset Stomach or Stomach Pain
  • Vomiting
  • Dark Urine or Light-Colored Stool
  • Joint Pain
  • Fever
  • Diarrhea

The CDC and other health professionals recommend prevention via vaccination, escalated handwashing and improved hand hygiene.


With the Public Health Emergency in effect, it is important to review what the experts suggest.

As Food Safety Science Advisor at GOJO, I recommend the following criteria for the public and foodservice workers in areas affected or near a hepatitis A outbreak.

1. Know the Symptoms

Know the symptoms of hepatitis A. Make sure you are self-monitoring for symptoms like fever, lethargy, loss of appetite, nausea, vomiting, abdominal cramping and yellowing of skin and eyes. It is important to restrict employees from reporting to work in a food establishment if they show symptoms or have been diagnosed with the virus.

2. Educate People on the Risks

Educate friends, families and co-workers on the risk of hepatitis A virus. If you are a business owner, engage local health departments or educational partners for support.

3. Emphasize Good Hygiene Practices

One of the easiest preventative measures is proper handwashing done frequently (wash for 20 seconds with soap and water).

4. Vigilant Cleaning Practices

Be vigilant about cleaning and sanitizing. Be sure to routinely disinfect high-risk areas with a product that has a quick hepatitis A kill claim, such as PURELL® Surface Disinfecting Spray or PURELL® Foodservice Surface Sanitizer.

5. Vaccinate

Know that hepatitis A virus is preventable with a vaccine. It’s two shots, 6-months apart, but provides lifelong immunity. If your business’ budget allows, consider administering a vaccine campaign.

The Public Health Emergency is up to 60 days long4, some professional surface disinfectants can kill hepatitis A in 60 seconds. It doesn’t take long for an outbreak to occur, but preventative measures can be taken that don’t take up much time.

In other words, proper handwashing, self-monitoring for symptoms and effective products and services can help stop the spread of the virus on high-touch surfaces.

For more information on hepatitis A in foodservice, download the “Hepatitis A Virus: A Significant Foodborne Pathogen” bulletin.

PURELL® Surface Sprays kill hepatitis A in 60 seconds. For more information, visit https://www.gojo.com/Product-Catalog/PURELL-Surface.

1. Retrieved on Aug. 13, 2019. http://www.floridahealth.gov/diseases-and-conditions/vaccine-preventable-disease/hepatitis-a/surveillance-data/
2. Retrieved on Aug. 13, 2019. http://www.floridahealth.gov/newsroom/2019/08/080219-state-of-florida-department-of-health-declaration-of-public-health-emergency.pr.html
3. Retrieved on Aug. 13, 2019. https://www.cdc.gov/hepatitis/outbreaks/2017March-HepatitisA.htm
4. Retrieved on Aug. 13, 2019. https://www.usatoday.com/story/news/nation/2019/08/03/florida-hepatitis-a-what-know-public-health-emergency/1909061001

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