CBC MARKETPLACE: HEALTH » HEPATITIS
Food handling and the risks
of hepatitis A
October 8, 2002 | Reporter: Erica Johnson; Producer: Gaelyne
Leslie; Researcher: Marlene McArdle
Bob Hastings needed a
liver transplant to survive his bout with hep A
Over the past 20 months, more than 45,000 Canadians have
lined up to be
against hepatitis A, a virus that
attacks the liver.
The easiest way to contract the virus is by eating food
that was handled by food service workers with poor hygiene
habits: they don't wash their hands properly after using the
What's to prevent it from happening again? Marketplace
travelled to St. Louis, Missouri to see how that city has
tackled the problem.
Sept 2002: 16,270 people after hep-A turns
up at a Sobey's store in London, ON
July 2002: 18,569 people after a Loblaw's worker
in Toronto tests positive for hep-A
Mar 2002: 6,100
after food handler
contracts hep-A at Caper's grocery/deli in Vancouver
Jan/Feb 2001: 5,400
after food handler
tests positive at a SuperStore deli/grocery in
Recent Hep-A Inoculations
Bob Hastings was the picture of health three years ago -an
avid tennis player in his 50's- until shortly after eating
at his favourite lunch spot.
came down with what he thought were flu symptoms. Hours later,
he was rushed to hospital, unconscious.
Doctors discovered massive damage to his
liver, from hepatitis A. His family was told to prepare for
the worst. Hastings was given 36 hours to live. A liver transplant
saved his life.
Hastings was one of 68 people who contracted hepatitis A
from eating at that restaurant. Health officials went to the
restaurant and made an unappetizing discovery about one of
the sandwich makers.
"They literally caught him red-handed," Hastings
told Marketplace. "He literally had excrement
under his fingernails, which is the way hep A is passed."
The outbreak caught the attention of St. Louis city councillors.
They came up with a plan to make it mandatory for all food
handlers to be vaccinated against hepatitis A. Hastings made
an emotional plea for the plan, from hospital in the days
after his transplant operation.
'We wanted to be pro-active
and not reactive,' says Janet Williams of the St. Louis
County Health Department
The image was enough to persuade lawmakers to adopt the plan.
Janet Williams works for the St. Louis County Health Department.
"As a public health agency, we’re always looking
at a way to prevent illness rather than continue to respond
to an outbreak and this was a way for us to be pro-active
and not reactive," she said.
Under the program, anyone who handles ready-to-eat food is
vaccinated. The shots are paid for by the employer, although
often the employee winds up footing the bill.
Once someone's vaccinated, they're issued a card and their
name is registered on a central computer. That means there's
a record on file if food handlers switch jobs. People who
are not vaccinated have 10 days to get it done - or they're
fired. The only exceptions:
- Pregnant women
- People with medical issues
- People with religious objections
The St. Louis hepatitis A vaccination program has been in
place for two years. Several other American jurisdictions
have similar programs. In Canada, the idea is getting the
Mandatory vaccinations 'may not be worth
In Vancouver, Dr. Patricia Daly tracks communicable diseases
for the city's health department. She says food handlers are
just a small part of Canada's hepatitis A problem - most infections
are brought in by travellers who pick it up overseas.
Dr. Patricia Daly of
the Vancouver health department says food handlers are
a small part of the hep A problem
"I think if we look back over the last five or 10 years,
the number of people who acquired hep A from a food handler
in a restaurant is very small in Canada."
Ten people have developed hepatitis A after recent scares
- the most recent confirmed case was the day before this story
But, on top of the inconvenience, vaccinating more than 45,000
people has cost taxpayers more than $1 million. A mandatory
program would likely be paid for by employers and employees.
Daly suggests the cost may not be warranted.
Vancouver recently set up a voluntary vaccination program.
But, of 50,000
workers, fewer than 600 have signed
up. Two restaurants - Carmelo's Ristorante Italiano and Amadeo
Bakehouse and Coffees - allowed our cameras to videotape
their employees getting the shot.
Proper handwashing is Canada's answer
In Canada people in the food business prefer to stick with
Mom's old admonishment: "Wash your hands!"
Proper handwashing takes
"Simple old-fashioned practices like thorough hand-washing
will certainly minimize the chances of spreading any communicable
disease and that’s why they’re emphasized,"
Joyce Reynolds of the Canadian Restaurant Association told
At Toronto's George Brown College, Lloyd Suydeko dispenses
the art of handwashing to food service students.
Before going through the six steps of handwashing, he has
his students use crayons - treated with an invisible germ
simulator - to trace around their hands.
After thoroughly washing their hands, the students are surprised
to discover how much of the germ simulator remained on their
hands and clothes.
Later, the students head out to restaurants with an informal
survey to find out what food service workers know about hand
Among the students' findings:
- Several restaurants did not display signs informing staff
to wash their hands.
- Several restaurant workers were not well acquainted with
proper hand washing techniques.
- One worker didn't know what "tepid water" meant.
Chances are slim that what you eat will give you hepatitis
A. But unless something changes, you could find yourself in
a long line-up, waiting for a hepatitis A shot, wondering
if mandatory vaccines are the answer. For now, the fate of
your food rests in the hands that handle it.
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