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Food Safety Savvy: Hepatitis A 

By Jean Dible, GA Food Safety Professionals

Your Food Safety Connection

Hepatitis A is a disease that most people have heard of, but really know very little about. In fact, the average person does not know if Hepatitis A is a bacteria, virus, parasite, or combined pathogens that lead to severe illness in human beings. No more doubt, Hepatitis A is a virus!

"Hepatitis A is the most common vaccine-preventable disease in the United States."

A virus relies on a living cell to reproduce, but unlike bacteria, viruses cannot reproduce in food. Even though viruses cannot reproduce in food, some viruses can remain dormant in food and even survive freezing and cooking of the food. Once a human has eaten the food, the dormant viruses then have live tissues inside the human body, which help them to reproduce. The Hepatitis A virus is very slow growing, and the incubation period of the virus can take from 10 to 50-days, but the average time is approximately 30-days.

Hepatitis A is a serious disorder or contagious virus in which the human liver cells become inflamed. The symptoms are mild or no illness, then sudden onset of fever, general discomfort, fatigue, headache, nausea, loss of appetite, vomiting, abdominal pain, and jaundice (yellowing of the skin & eyeballs) after several days. The duration of the illness is 1 to 2-weeks; severe cases may last several months. About 200,000 cases of Hepatitis A are reported annually in the United States, and about 100-Americans die from the disease yearly. Half the reported cases are school–aged children because children tend to put things in their mouths that may look clean, but have been contaminated with the stool of a person with the virus, who has not washed his/her hands properly. Children then bring the virus into the home and contaminate other family members.

Two sources for Hepatitis A will always be the human intestinal tract and feces-contaminated water. If a person is carrying the active Hepatitis A virus and does not wash their hands properly, everything they touch will transmit the virus from their hands to other objects, and of course, food. For approximately 50% of persons with Hepatitis A infection, no source has ever been identified for their illness. It is safe to say that the virus has to get into the body, and in most cases, it is through the mouth in the form of food. Other ways of getting the Hepatitis A virus is through exchanging body fluids and needles, which is less common.


Ready to eat foods usually involved in Hepatitis A outbreaks are: water and ice, shellfish, salads, deli meats and sandwiches, fruits and juices, dairy products, vegetables, and any food that will receive no further heat treatment.

Shellfish are especially “friendly” to viruses because shellfish pump water through their bodies and thus, concentrate food and contaminates, such as viruses, from the water. Once the virus is on or in the shellfish, a live host, it may persist for a longer time than if it were suspended in the water. Since some shellfish are eaten raw or lightly cooked, this increases the risk of foodborne illness.


Produce used for salads, lettuce, spinach, etc.; grow low to the ground where they are more likely to be exposed to contaminated, organic fertilizers, such as manure. In addition, produce is often irrigated with contaminated waters or picked by farm workers with poor hygiene practices. There is no heating step in salad ingredients that would inactive a virus, regardless of how many times catering employees might wash produce for salads.

"For approximately 50% of persons with Hepatitis A infection, no source has ever been identified for their illness."

As the Flight Attendants readers can imagine from the information presented so far, Hepatitis A can come from many different sources, and there is only one safe way to protect your self. Hepatitis A is the most common vaccine-preventable disease in the United States. All County Health Departments throughout the United States offer Hepatitis A vaccines, and these vaccines are your key to protection. The Hepatitis A vaccines are given in shot form in two doses, and the vaccines are usually spaced 6-12 months apart. The first dose of Hepatitis A vaccine can be assumed to protect a person within 4-weeks after injection. Completion of the vaccine series, according to schedule, is necessary for long-term protection. The cost for each dose of Hepatitis A vaccine administered through a public County Health Dept. is about $85. Once the two vaccine doses have been taken, the immunity is life long.

Since the 1960’s, the majority of Hepatitis A cases in the United States have occurred in a limited number of states and counties in the western and southwestern United States. (Alaska, Arizona, California, Idaho, Nevada, New Mexico, Oklahoma, Oregon, South Dakota, Utah & Washington).

For those flight attendants who do international travel, during 2002-2004, approximately 75% of all travel-related Hepatitis A cases were directly associated with travel to Mexico or Central or South America. The entire continent of Africa, Arabia, and all countries in Asia are also extremely high-risk areas for Hepatitis A.


  • CDC: Center For Disease Control: Atlanta, GA

  • GA Division of Public Health

  • American Liver Foundation

  • ServSafe Essentials – Fourth Edition

Author Information:


Jean Dible is president and founder of GA Food Safety Professionals, a mobile food & alcohol safety training school in Atlanta, GA. Jean is a contributing writer to the Corporate Flight Attendant Community website; her Your Food Safety Connection column will appear on a bi-monthly basis.