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Hockey takes a shot from Hepatitis A

16.may.05, Ben Chapman, Commentary from the Food Safety Network

This is usually my favourite time of year -- springtime brings the NHL playoffs. Normally it's non-stop hockey on television, in the news and on my mind. Though the World Championships have just ended in Austria, it just was not the same. I sat this one out and I wasn't the only one. Patrick Elias of the gold medal-winning Czech Republic and the New Jersey Devils , yearly foe of my beloved Toronto Maple Leafs, was also on the shelf.
But Elias didn't miss the Championships as a result of indifference towards international hockey. Elias didn't play because he's been battling a hepatitis A infection that he's had since March. The Czech winger spent four weeks in the hospital, lost about 30 pounds, missed the remainder of the Russian hockey season (where he had been playing to pass the time) and finally the World Championships. All this due to what his agent described as bad seafood in a Russian airport. Elias is one of an increasing number of people to fall victim to this sneaky virus.
Hepatitis A has a low infectious dose -- only a few virus particles are needed to make someone sick. Once infected, a person can shed the virus and infect others without showing any symptoms for up to 30 days. The dreaded fecal-oral route is the main contamination method. The best way to control it, and many other foodborne illnesses, is by practicing the basics -- good personal hygiene and handwashing. Seems simple enough but hepatitis A, traditionally a problem in the raw seafood industry (when shellfish are harvested from waters contaminated by sewage), is becoming an increasingly bigger problem in fresh produce, restaurants and grocery stores.
In the fall of 2003, over 900 people were infected in four separate outbreaks traced to green onions supplied to U.S. restaurants by Mexican farmers. The cost of this outbreak has been in the millions of dollars for the farmers and the restaurants involved, not to mention monetary and health costs suffered by those sickened with the virus. According to Mexican growers, the market impact of this outbreak lasted up to four months while prices fell 72 per cent. The Mexican green onion industry is still rebuilding as the U.S. has imposed import restrictions on their product. An inspection by the U.S. Food and Drug Administration suggested, that workers at one of the four Mexican green onion farms implicated in the outbreak lived in squalor. Showers were unavailable and trenches ran from an area littered with soiled diapers and human waste into the suspect onion fields. The basics of food safety, by North American standards, were not being followed.
In the past month, thousands of people have been exposed to hepatitis A through at least three venues -- a Waffle House in Tennessee, a cafeteria in California, and a local restaurant in Virginia. But this isn't just a strictly American problem, like some Canadians may think. In 2002, thousands were exposed to the virus because of ill workers at two grocery stores in southern Ontario. Following each of these incidents, potentially exposed customers were urged to get immune globulin shots to combat the infection and contain the outbreak. The result of all these exposures, as is becoming increasingly common in outbreaks, was legal action. A class action lawsuit was filed four days after one of the Ontario grocery store
exposures and settlements for the other outbreaks total in the tens of millions of dollars.
There have been suggestions from regulators and food industry spokespeople to mass vaccinate all food handlers for hepatitis A. Notwithstanding the potential religious discrimination for employees who believe vaccinations are unholy, this is a costly venture. In an industry wrought with high employee turnover, vaccinations may not be an effective solution -- and could provide the wrong message to food handlers. Handwashing and personal hygiene are paramount in reducing foodborne illnesses and providing a vaccination may allow some employees to get sloppy with the basics. Vaccination only protects against hepatitis A, but there are other bugs out there such as E. coli that must not be forgotten.
Food handlers are the key to reducing hepatitis A infections (and many foodborne illnesses) and good managers are the drivers. In food handling and hockey alike, a good team leader who vigilantly practices the basics can instill the same values into his or her team. With all that is going on, it is timely that Health Canada has recognized May as Hepatitis Awareness month (http://hc-sc.gc.ca/ english/media/minister/message_hep_2005.html). But I doubt that Patrick Elias will volunteer to be the spokesperson in 2006.

Ben Chapman is a die hard Toronto Maple Leafs fan and a graduate student with the Food Safety Network at the University of Guelph. The Food Safety Network's national toll-free line for obtaining food safetyinformationis 1-866-50-FSNET (1-866-503-7638) and further information is available at www.foodsafety.ksu.edu

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