2018-05-02 / Front Page

Increasing hepatitis A activity in southern Indiana counties

The Indiana State Department of Health (ISDH) and several local health departments are investigating increasing hepatitis A activity in southern Indiana counties. Since January 1, 2018, 40 confirmed cases have been identified, compared to an average of 20 cases statewide each year. Many of these cases have reported travel to Louisville or contact with people who recently traveled to Louisville, where an ongoing community outbreak is occurring. Three of these cases prepared or served food while infectious.

Hepatitis A is a viral infection of the liver. Symptoms appear 15-50 days after exposure and may include abdominal pain, fatigue, nausea, vomiting, diarrhea, dark urine, pale (clay-colored) stool, and jaundice (yellowing of skin and eyes). Hepatitis A virus is shed in stool and is spread by contaminated food, beverages, and ice through unwashed hands and person-to-person contact with people who are infected. People who are infected shed the virus for about three weeks before and after symptoms appear.

The Indiana Retail Food Code (410 IAC 7-24) requires food employees and applicants to report a diagnosis of hepatitis A, symptoms of hepatitis A, exposure to hepatitis A, or contact with a household member diagnosed with hepatitis A to the person in charge of the food establishment. According to the Indiana Communicable Disease Reporting Rule (410 IAC 1-2.5), food employees must be excluded from any employment involving food handling if the employee has experienced jaundice in the past seven days or is diagnosed with hepatitis A within the past 14 calendar days from the onset of any symptoms (or within the past seven days if jaundice is present). Persons-in­charge are strongly urged to contact their local health department immediately if they suspect that a food employee may have hepatitis A.

Although not required, food employees are encouraged to receive hepatitis A vaccine, which is safe and effective in preventing hepatitis A. The two-dose vaccination series can be obtained through healthcare providers and pharmacies. If a food employee is diagnosed with hepatitis A, public health officials will work with the food establishment to provide vaccine to other food employees. Any food employee who declines vaccination will be restricted from working with exposed food; clean equipment, utensils, and linens; and unwrapped, single-service and single-use articles for 50 days from the date of the last exposure. Appropriate hand washing is also important in preventing hepatitis A.

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