Hepatitis A is the only common vaccine-preventable foodborne disease in the United States. Infection with the hepatitis A virus can lead to acute liver failure and death. Hepatitis A is totally and completely preventable. Although outbreaks continue to occur in the United States, no one should ever get infected if preventive measures are taken. For example, in addition to vaccines, food handlers must always wash their hands with soap and water after using the bathroom, changing a diaper, and certainly before preparing food. Food handlers should always wear gloves when handling or preparing ready-to-eat foods, although gloves are not a substitute for good hand washing.

Hepatitis A is much more common in countries with underdeveloped sanitation systems and, thus, is a risk in most of the world. An increased transmission rate is seen in all countries other than the United States, Canada, Japan, Australia, New Zealand, and the countries of Western Europe.

Hepatitis A is a communicable disease that often spreads from person to person. Person-to-person transmission occurs via the “fecal-oral route,” while all other exposure is generally attributable to contaminated food or water. Food-related outbreaks are usually associated with contamination of food during preparation by a hepatitis A-infected food handler. The food handler is generally not ill because the peak time of infectivity-that is, when the most virus is present in the stool of an infected individual-occurs two weeks before illness begins.

Fresh produce contaminated during cultivation, harvesting, processing, and distribution has also been a source of hepatitis A. In 1997, frozen strawberries were the source of a hepatitis A outbreak in five states. Six years later, in 2003, fresh green onions were identified as the source of a hepatitis A outbreak traced to consumption of food at a Pennsylvania restaurant. Other produce, such as blueberries and lettuce, has been associated with hepatitis A outbreaks in the U.S.

Hepatitis A may cause no symptoms at all when it is contracted, especially in children. Asymptomatic individuals will only know they were infected (and have become immune, given that you can only get hepatitis A once) by getting a blood test later in life. Approximately 10 to 12 days after exposure, hepatitis A is present in blood and is excreted via the biliary system into the feces. Although the virus is present in the blood, its concentration is much higher in feces. Hepatitis A excretion begins to decline at the onset of clinical illness and decreases significantly by 7 to 10 days after onset of symptoms. Most infected persons no longer excrete virus in the feces by the third week of illness; children may excrete hepatitis A longer than adults.

Symptoms typically begin about 28 days after contracting hepatitis A but can begin as early as 15 days or as late as 50 days after exposure. The symptoms include muscle aches, headache, anorexia (loss of appetite), abdominal discomfort, fever, and malaise. After a few days of typical symptoms, jaundice (also termed “icterus”) sets in. Jaundice is a yellowing of the skin, eyes and mucous membranes that occurs because bile flows poorly through the liver and backs up into the blood. The urine will also turn dark with bile and the stool light or clay-colored from lack of bile.

In general, symptoms usually last less than 2 months, although 10% to 15% of symptomatic persons have prolonged or relapsing disease for up to 6 months. It is not unusual, however, for blood tests to remain abnormal for six months or more. The jaundice so commonly associated with hepatitis A can also linger for a prolonged period in some infected persons—sometimes eight months or more. Additionally, pruritus, or severe “itchiness” of the skin, can persist for several months after the onset of symptoms.

Fulminant hepatitis A is a rare but devastating complication of hepatitis A infection. As many as 50% of individuals with acute liver failure may die or require emergency liver transplantation. The fulminant form of hepatitis occurs when this necrotic process kills so many liver cells—upwards of three-quarters of the liver’s total cell count—that the liver can no longer perform its job. Aside from the loss of liver function, fulminant hepatic failure can lead to encephalopathy and cerebral edema.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Hepatitis A outbreaks. The Hepatitis A lawyers of Marler Clark have represented thousands of victims of Hepatitis A and other foodborne illness outbreaks and have recovered over $800 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation. Our Hepatitis A lawyers have litigated Hepatitis A cases stemming from outbreaks traced to a variety of sources, such as green onions, lettuce and restaurant food. The law firm has brought Hepatitis A lawsuits against such companies as Costco, Subway, McDonald’s, Red Robin, Chipotle, Quiznos and Carl’s Jr. We proudly represented the family of Donald Rockwell, who died after consuming Hepatitis A tainted food and Richard Miller, who required a liver transplant after eating food at a Chi-Chi’s restaurant.

If you or a family member became ill with a Hepatitis A infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Hepatitis A attorneys for a free case evaluation.