Health Department urging restaurants to take hepatitis A precautions

A recent increase in hepatitis A cases in the state has the Indiana and Putnam County Health Departments warning restaurants to take precautions against this viral infection.

While nothing has happened in this general area of the state, the 40 cases so far in 2018 — up from about 20 annually — has the Indiana State Department of Health (ISDH) taking notice and encouraging action on the part of county health departments.

That’s exactly what the Putnam County Health Department did this week, sending out letters to all food establishments and mobile food vendors in the county.

The letter, signed by Nicole Stone, foodborne and waterborne disease epidemiologist for ISDH, reports that many of the cases have links to the Louisville, Ky., area, where and ongoing community outbreak is occurring.

“Three of these cases prepared or served food while infectious,” Stone wrote.

While Louisville is not all that nearby, travel to the Louisville area is still common, especially with many families haven taken vacations in recent weeks.

“The concerning part was down in southern Indiana,” Putnam County environmental health specialist Jessica Watson confirmed for the Banner Graphic. “But people were traveling around spring break. There were some that were still working and didn’t know they were ill.”

Hepatitis A is a liver infection caused by hepatitis A virus. Highly contagious, the virus is usually transmitted by the fecal-oral route, either through person-to-person contact or consumption of contaminated food, beverages or ice.

Contamination can occur when infected persons do not wash their hands properly after using the restroom and then touch other objects or food items.

The letter reminds food retailers that the Indiana Retail Food Code requires food employees and applicants report to the person in charge of a food establishment any diagnosis of, symptoms of or exposure to hepatitis A, as well as contact with a household member with the disease.

At that point, the Indiana Communicable Disease Reporting Rule requires that employees must be excluded from any employment involving food handling if the have experienced jaundice in the last seven days or have been diagnoses with hepatitis A within the last 14 days.

“Persons-in-charge are strongly urged to contact their local health department immediately if they suspect that a food employee may have hepatitis A,” Stone wrote.

While the hepatitis A vaccine is recommended, it is not required unless a diagnosis has occurred at a particular establishment. Both healthcare providers and pharmacies can provide the two-shot vaccine.

“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,’ Stone wrote. “Any food employees 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 last exposure.”

Of course, the ideal situation is prevention, so health officials are urging steps to stop an outbreak before it can even start.

“We can prevent it from happening. We just need to stay on top of it,” Watson said. “There is prevention out there. We just need to make sure we know what we’re doing and what to look for when someone is sick.”

Perhaps the easiest step is hand washing, which should include thoroughly washing hands and arms with soap and warm water for at least 10 to 15 seconds and thoroughly rinsing with clean, running water and properly drying.

Hand washing signs should also be posted in the appropriate locations.

Surfaces that are frequently touched should also be cleaned and sanitized often, including: recreation equipment and railings, toilet room surfaces, kitchen surfaces, doorknobs, light switch plates, phones, computer keyboards, high chairs, tables and chairs, remote controls and wheelchairs and walkers

Further information on hepatitis A disinfection for food facilities is available at http://putnamhealthindiana.org/FoodSafety.html.

Anyone with questions may also call the Putnam County Health Department at 658-2784.