A recent case of Hepatitis A at Starbucks:
It was a panic-filled day at a Starbucks in Blackwood, New Jersey. An employee tested positive for Hepatitis A and was contagious while working closely with coworkers and serving customers. When the Camden County Health Department was notified of the positive case, the Starbucks was closed and both customers and workers were encouraged to get Hepatitis A post-exposure treatment.
What is Hepatitis A?
Hepatitis A (HAV) is a member of the picornavirus family that infects the liver. “Hepa” comes from the Latin word for liver “Hepar” and anything with “itis” means inflammation. It is highly contagious if you come in contact with the virus. You can get infected if you come in contact with an infected person’s stool, either by close contact with that person or ingesting contaminated food or drinks. The average time for the appearance of symptoms after exposure to the virus is 28 days. Initial symptoms include fever, loss of appetite, nausea, vomiting, diarrhea, fatigue, yellow-tinged urine or stool and yellowish skin.
Who is at Highest Risk of Infection?
This is a really contagious virus, but people at highest risk include those who inject drugs, those who travel to countries with poor sanitation, those who eat/drink food or beverages contaminated with the stool of an infected person, and those who have sex, especially anything involving the oral-anal route.
What Should those Starbucks Coworkers and Customers Do?
In short, assess their risk with the help of a public health expert and possibly get postexposure treatment. Becaues Hepatitis A is so contagious, and because it is transmitted via infected food or drinks, a positive restaurant worker is a most concerning case. He/she has the potential to infect hundreds of people quickly, simply because of the nature of his/her work. It also can be a costly public health intervention. For example, a foodborne Hepatitis A outbreak in Denver, Colorado that led to at least 43 cases of Hepatitis A cost the public health department more than 800,000 dollars in postexposure prophylaxis costs. Speaking of high postexposure costs, I covered the insanely high cost of Rabies postexposure costs here, a cost you should never skip out on paying, because Rabies will kill you.
What is Postexposure Prophylaxis (PEP) ?
“Phylax” is the Greek word for “Guard” so prophylaxis means taking measures to guard someone from a disease ahead of time. If the Starbucks customers and coworkers decide to get postexposure prophylaxis, based on current CDC guidance, they will receive a Hepatitis vaccine, ideally within 2 weeks of exposure, if they are currently unvaccinated. In addition, they may also receive an immunoglobulin called GamaSTAN S/D ,which is estimated to be over 85% effective in preventing Hep A if given within 2 weeks after exposure. Immunoglobulins are specialized proteins, sometimes called antibodies, that can recognize specific parts on viruses, bind to them, and prevent them from making you sick.
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