It is Past Time to Vaccinate Restaurant Workers Against Hepatitis A.

In reaction to the news that a sick worker at a Springfield Red Robin may have exposed more than 5,000 people to Hepatitis A, Bill Marler, a Seattle-based attorney who specializes in food safety issues, is questioning why restaurant workers aren’t required to be vaccinated for the disease.

“It’s ridiculous that states, counties, and the restaurant industry haven’t come together to eliminate this threat. Hepatitis A is a serious disease, but it’s also the only food-borne illness that is vaccine-preventable. There is no reason not to vaccinate all restaurant workers; it is the right and moral thing to do,” said Marler. The Centers for Disease Control has repeatedly pointed out that the consumption of worker-contaminated food is a major cause of foodborne illness in the U.S.

The problem of Hepatitis A exposure from infected restaurant workers to consumers is prevalent and widespread. In just the last few months, several restaurants, including a Papa John’s in North Carolina and La Fontana in suburban New York have issued exposure warnings. Earlier this month, a Red Robin in Pennsylvania was investigated by the Department of Health after an employee tested positive.

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. 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.

The 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 food-borne 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 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.

ABOUT BILL MARLER

Bill Marler is an accomplished food safety advocate and attorney. He began litigating foodborne illness cases in 1993, when he successfully represented Brianne Kiner, the most seriously injured survivor of the Jack in the Box E. coli O157:H7 outbreak. Over the years, Bill and his firm, Marler Clark, have become the leaders in representing victims of foodborne illness, and have gone against companies that include Odwalla, Chili’s, ConAgra, Dole, KFC, Sizzler, Golden Corral and Wendy’s.

Bill spends much of his time traveling to address food industry groups, fair associations, and public health groups about foodborne illness, related litigation, and surrounding issues. He has testified before Congress as well as State Legislatures. He is a frequent author of articles related to foodborne illness in food safety journals and magazines as well as on his personal blog, www.marlerblog.com. Bill also recently founded Food Safety News (www.foodsafetynews.com) as a one-stop resource for global food safety news and information.