Hepatitis A – Is it a Risk in Canada?
Many people think that Hepatitis A is only a risk when travelling to developing countries. While there is a much higher risk of Hepatitis A in developing countries, risk may also exist in Canada in high-risk groups or during community outbreaks. Thankfully outbreaks are rare but have been associated with imported food contaminated with Hepatitis A or from infected food handlers who can potentially pass the virus on to patrons.
The facts about Hepatitis A
Hepatitis A is a virus that attacks the liver. It is spread though food and water contaminated by the feces of an infected person. It is more common in developing countries with poor sanitary conditions. It is one of the most common vaccine-preventable infections acquired during travel.
Symptoms begin between 15-50 days after infection with Hepatitis A. However, people are most infectious 1-2 weeks before symptoms begin. Infection may cause no symptoms or range in severity from mild illness to a severe disease lasting several months. Symptoms may include sudden fever, fatigue, nausea, vomiting, abdominal pain, dark-coloured urine and jaundice (yellowing of the skin and whites of eyes). The chance of having symptoms and the severity of the disease increases with age. Most children < 6 years of age who are infected do not have symptoms. In developing countries most children have been infected before 10 years of age so epidemics are less common as older children and adults are mostly immune.
Hepatitis A in Canada
Thankfully in developed countries such as Canada the chance of getting Hepatitis A infection is generally low. The disease may be more common in high-risk groups such as homosexual men, intravenous drug users, and those living in areas with inadequate sanitation. The number of people infected with Hepatitis A in Canada has been steadily decreasing due to targeted vaccination in these high-risk groups.
Outbreaks of Hepatitis A in Canada are generally rare but exposures have occurred in supermarkets, restaurants, and elementary schools.
These outbreaks serve as a reminder that Hepatitis A is not only a risk in developing countries. While food handlers aren’t at an increased risk because of their jobs, workers in restaurants and supermarkets can help prevent the spread of Hepatitis A.
How can food handlers prevent the spread of Hepatitis A?
- ALWAYS wash hands thoroughly with soap and water after using the bathroom
- Do not handle food if experiencing fever, vomiting or diarrhea
- Get vaccinated!
Hepatitis A Vaccine
Receiving the Hepatitis A vaccine is the best way to prevent Hepatitis A infection. It is available on its own or in combination with Hepatitis B (Twinrix).
The Hepatitis A vaccine is given in 2 doses between 6 to 12 months apart to individuals 6 months of age and older.
The Twinrix vaccine (Hepatitis A & Hepatitis B combined) is given in 3 doses at 0, 1 and 6 months.
Reactions to the vaccines are uncommon and usually minor including soreness and tenderness at the injection site.
Of course the Hepatitis A vaccine is also recommended before travel!