Hepatitis A in a food worker and subsequent prophylaxis of restaurant patrons.
* 8,795 acute cases were reported.
* A laboratory-confirmed hepatitis A patient was reported to Tri-County Health Department (TCHD) in Colorado on December 30, 2002.
* The individual with the case was determined to be an employee of a fast-food restaurant.
* TCHD conducted an environmental investigation of the restaurant and identified handwashing deficiencies.
* The restaurant manager reported that the ill employee had worked while infectious, had had frequent contact with ready-to-eat foods without gloves, and had not practiced proper hand hygiene.
* TCHD staff decided to hold a mass immunoprophylaxis clinic.
* A news release was issued advising restaurant patrons to get an immune globulin (IG) shot at the clinic.
* A total of 693 people received IG at the TCHD clinic.
* The clinic screened an additional 195 individuals who were determined to be ineligible to receive IG.
* All employees of the restaurant either received IG or were removed from the work schedule for the following 50 days.
* TCHD's Health Alert Network was used to fax a hepatitis A advisory to physicians informing them of potential exposure dates, symptoms, laboratory tests, and treatment for hepatitis A.
* Follow-up inspections of the restaurant were conducted over the next six weeks.
* No additional restaurant employees were ill, and no additional reported cases of hepatitis A were associated with the ill employee.
* The financial cost of holding the clinic totaled $48,300, or $69.70 per vaccine.
* All expenses were recovered from the restaurant corporation.
* Effective hepatitis A vaccine has been available in the United States since 1995.
* A substantial reduction in disease incidence has occurred in recent years.
* Currently, CDC's Advisory Committee on Immunization Practices (ACIP) recommends considering hepatitis A vaccine if health authorities or private employers deem it cost-effective.
* An economic analysis has determined that routine vaccination of restaurant workers may not be economical either from the perspective of the restaurant owner or from a societal perspective.
* The vaccine would prevent infection from only one of many enteric agents.
* Employers who want to reduce the risk of hepatitis A infection among employees, however, should focus on providing vaccine to people with risk factors for infection:
-- men who have sex with men,
-- illicit-drug users, and
-- people who travel to developing countries.
* Ultimately, the most cost-effective means of preventing foodborne illness is proper food preparation and good hand hygiene.
|Printer friendly Cite/link Email Feedback|
|Publication:||Journal of Environmental Health|
|Date:||Jul 1, 2006|
|Previous Article:||Analyzing acute-chemical-release data to describe chemicals that may be used as weapons of terrorism.|
|Next Article:||Analyzing acute-chemical-release data to describe chemicals that may be used as weapons of terrorism.|