Publisher’s Platform: Vaccinate restaurant employees against hepatitis A or suffer the consequences

Opinion

The RCAHD is currently investigating nine cases of hepatitis A associated with this exposure.

An employee who worked at three Famous Anthony’s restaurant locations in Roanoke has been diagnosed with hepatitis A. As a result, the Roanoke City and Alleghany Health Districts (RCAHD) announced today that anyone who visited any of these three Famous Anthony’s locations — 4913 Grandin Road, 6499 Williamson Road or 2221 Crystal Spring Ave. — from Aug. 10 through 26 only, may have been exposed.

To protect your health and prevent further spread of illness, if you meet these criteria and are not vaccinated against hepatitis A, please monitor yourself for these symptoms:

• jaundice: yellowing of the skin or the eyes,
• fever,
• fatigue,
• loss of appetite,
• nausea,
• vomiting,
• abdominal pain,
• dark urine, or
• light-colored stools.

If you develop any of these symptoms, please seek medical care and let your healthcare provider know of your possible exposure. It is also very important for people with symptoms to stay home from work, especially if they work in food service, health care or child care.

It is irresponsible for restaurants to not offer hepatitis A vaccines to employees. Or, ignore the issue, sicken your customers, and be assured, you will be sued.

A fact from the CDC: “Since the hepatitis A outbreaks were first identified in 2016, more than 39,000 cases, 24,000 hospitalizations, and 374 deaths as a result of hepatitis A virus (HAV) infection have been reported.”

True, some of the above have been the homeless or drug addicts, but how many of those work at restaurants?  Where exposed at restaurants? Note: 30 percent to 40 percent of the people impacted are NOT the homeless or drug addicts.

Hardly a day passes without a warning from a health department somewhere that an infected food handler is the source of yet another potential hepatitis A outbreak.

Absent vaccinations of food handlers, combined with an effective and rigorous hand-washing policy, there will continue to be more hepatitis A outbreaks. It is time for health departments across the country to require vaccinations of food-service workers, especially those who serve the very young and the elderly.

Hepatitis A is a communicable disease that spreads from person-to-person. It is spread almost exclusively through fecal-oral contact, generally from person-to-person, or via contaminated food or water. Hepatitis A is the only foodborne illness that is vaccine preventable. According to the U.S. Centers for Disease Control and Prevention (CDC), since the inception of the vaccine, rates of infection have declined 92 percent.

CDC estimates that 83,000 cases of hepatitis A occur in the United States every year and that many of these cases are related to foodborne transmission. In 1999, more than 10,000 people were hospitalized due to hepatitis A infections, and 83 people died. In 2003, 650 people became sickened, four died, and nearly 10,000 people got IG (immunoglobulin) shots after eating at a Pennsylvania restaurant. Not only do customers get sick, but also businesses lose customers, or some simply go out of business.

Although CDC has not yet called for mandatory vaccination of food-service workers, it has repeatedly pointed out that the consumption of worker-contaminated food is a major cause of foodborne illness in the U.S.

Hepatitis A continues to be one of the most frequently reported, vaccine-preventable diseases in the U.S., despite FDA approval of hepatitis A vaccine in 1995. Widespread vaccination of appropriate susceptible populations would substantially lower disease incidence and potentially eliminate indigenous transmission of hepatitis A infections. Vaccinations cost about $50. The major economic reason that these preventive shots have not been used is because of the high turnover rate of food-service employees. Eating out becomes a whole lot less of a gamble if all food-service workers faced the same requirement.

According to the CDC, the costs associated with hepatitis A are substantial. Between 11 percent and 22 percent of persons who have hepatitis A are hospitalized. Adults who become ill lose an average of 27 days of work. Health departments incur substantial costs in providing post-exposure prophylaxis to an average of 11 contacts per case. Average costs (direct and indirect) of hepatitis A range from $1,817 to $2,459 per case for adults and from $433 to $1,492 per case for children younger than 18. In 1989, the estimated annual direct and indirect costs of hepatitis A in the U.S. were more than $200 million, equivalent to more than $300 million in 1997 dollars.  A new CDC report shows that, in 2010, slightly more than 10 percent of people between the ages of 19 and 49 got a hepatitis A shot.

Vaccinating an employee make sense.  It is moral to protect customers from an illness that can cause serious illness and death. Vaccines also protect the business from the multi-million-dollar fallout that can come if people become ill or if thousands are forced to stand in line to be vaccinated to prevent a more serious problem.

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