Questions and Answers Regarding Potential Hepatitis A Virus Exposure and Consumption of Produce Purchased at Wegmans in Erie County

General Questions Regarding Hepatitis A Virus

What is hepatitis A?

Hepatitis A is caused by the hepatitis A virus. It is a highly contagious disease that attacks the liver. It is the most common type of hepatitis.

How is the hepatitis A virus spread?

Hepatitis A virus is usually spread from person to person by putting something in the mouth that has been contaminated by a person with hepatitis A. This type of transmission is called the "fecal-oral" route. For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed.

Most infections in the United States result from contact with a household member or sex partner who has hepatitis A. Hepatitis A virus may also be spread by consuming food or drink that has been handled by an infected person.

How soon do symptoms appear, i.e. what is the average incubation period for hepatitis A?

The symptoms commonly appear within 28 days of exposure, with a range of 15-50 days.

What are the signs and symptoms of hepatitis A virus infection?

Some persons, particularly young children, are asymptomatic. When symptoms are present, they usually occur abruptly and can include the following:

  • Fever
  • Tiredness
  • Loss of appetite
  • Nausea
  • Abdominal discomfort
  • Dark urine
  • Jaundice (a yellowing of the skin and whites of the eyes)

Children aged <6 years may not have any symptoms or if illness does occur, it is typically mild and not accompanied by jaundice.

Not everyone who is infected will have all of the symptoms.

When symptoms occur, how long do they usually last?

Symptoms usually last less than 2 months, although 10%–15% of symptomatic persons have prolonged or relapsing disease for up to 6 months.

Will I have hepatitis A for the rest of my life?

No. Hepatitis A does not become chronic.

For how long is an infected person able to spread the virus?

The contagious period begins about two weeks before symptoms appear and lasts about one week after symptoms appear.

Can persons become reinfected with hepatitis A virus after recovering from hepatitis A?

No. Infection with hepatitis A provides lifelong protection against the disease. Once an individual recovers from hepatitis A, he or she cannot be re-infected. He or she is immune for life and does not continue to carry the virus.

What is the treatment for hepatitis A?

There are no special medicines or antibiotics that can be used to treat a person once the symptoms appear. Generally, bed rest is all that is needed.

How long does hepatitis A virus survive outside the body? How can the virus be killed?

Hepatitis A virus can live outside the body for months, depending on the environmental conditions. The virus is killed by heating to an internal temperature of 185°F (85°C) for 1.5 minutes. However, the virus can still be spread from cooked food if it is contaminated after cooking.

How can hepatitis A be prevented?

Good hygiene — including handwashing or use of hand sanitizer after using the bathroom, changing diapers, and before preparing or eating food — is essential to hepatitis A prevention, given that the virus is transmitted through the fecal–oral route.

For long-term protection, vaccination with the full, two-dose series of hepatitis A vaccine is the best way to prevent hepatitis A virus infection. Hepatitis A vaccine has been licensed in the United States for use in persons 12 months of age and older.

Immune globulin is available for short-term protection (approximately 3 months) against hepatitis A, both pre- and post-exposure. Immune globulin must be administered within 2 weeks. If given within two weeks of exposure, IG prevents clinical illness in more than 85 percent of recipients.

What Should I Do If I Have Been Exposed To Hepatitis A?

Persons who have recently been exposed to hepatitis A virus and who have not been vaccinated previously should be administered immune globulin or hepatitis A vaccine as soon as possible.

Questions Regarding Potential Exposure Following Shopping at Wegmans in Erie County

I heard about a hepatitis A infection at Wegman's. Can you tell me what happened?

A produce handler who worked at Wegmans 5275 Sheridan Drive, Williamsville, NY has been diagnosed with hepatitis A infection. The produce handler worked while potentially infectious on several dates in January and February. Because it is likely the employee followed good hand hygiene and food safety practices, the risk of exposure is small. However, the Erie County and New York State Department of Health have decided to provide preventative treatment to anyone who may have been exposed.

I shop at Wegman's, how do I know if I am at risk?

You may be at risk for hepatitis A infection if:

  • You purchased fresh produce (raw fruits and vegetables), either loose or in a perforated container, at the Wegman's Food Market at 5275 Sheridan Drive, Williamsville, NY between January 7th and February 8th
    AND
  • You consumed this produce uncooked.

If you had hepatitis A virus infection in the past or received the complete 2-dose series of hepatitis A virus vaccine you are immune to hepatitis A virus infection and are NOT at risk.

What should I do if I am at risk?

If you are ill, you should go see your primary care physician for evaluation and management as needed.

If you are not ill and think you may have consumed potentially contaminated food during the past 2 weeks, and have not previously been vaccinated for hepatitis A virus, you should get treatment as soon as possible.

Erie County Health Department has set up a clinic for Saturday, February 9, 2008 from 4:00 P.M. to Midnight at Erie County Community College (ECC) North Building S cafeteria. Additional clinic hours will be available at this same location on Sunday, February 10, 2008 from Noon to 8:00 P.M.

If you purchased produce from this Wegman's location after January 7, 2008 but ate it more than 14 days ago, you should watch for symptoms of hepatitis A. If you experience symptoms, please contact your medical provider. The hepatitis A vaccine or IG treatment will not prevent illness in people exposed prior to 14 days ago.

Am I at risk if I only had one dose of the hepatitis A virus vaccine?

Although it is likely to provide some protection, it is likely to be less effective than if you had received both doses. Therefore, if you have received only one dose of HAV vaccine and consumed potentially contaminated produce, you should get a second dose of vaccine.

If you have symptoms or are concerned, go see your physician.

It is important to realize that no vaccine is 100% effective. If you have symptoms consistent with hepatitis and are concerned, go see your healthcare provider.

How do I know if I cooked my produce sufficiently?

Hepatitis A virus is killed by heating to an internal temperature of 185°F (85°C) for 1.5 minutes.

Should I get tested?

You don't need to get tested if you don't have symptoms. If you do have symptoms or have additional questions or concerns, go see your primary care physician.

I have fresh vegetables and/or fruit at home. What should I do?

If the produce or fruit purchased was loose or in a perforated container at Wegman's at 5275 Sheridan Drive, Williamsville, NY between January 7 and February 8, 2008, you should discard it. Otherwise, you don't need to do anything.

Wegmans will issue refunds to any customer who believes they purchased potentially affected products, but asks that customers dispose of the products at home. Products should not be presented to Wegmans to receive a refund.

Should I get my food tested?

No, there is no test to determine if food is contaminated. If you are concerned about any product you should throw it out.

Sources:
CDC. Prevention of Hepatitis A Through Active or Passive Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2006; 55(No. RR-7).

CDC. Update: Prevention of Hepatitis A After Exposure to Hepatitis A Virus and in International Travelers. Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2007;56:1080–4.

Victor JC, Monto AS, Surdina TY, et al. Hepatitis A vaccine versus immune globulin for postexposure prophylaxis. N Engl J Med 2007;357(17):1685-94.